[Hormonal therapy in metastatic prostatic cancer]

For more than sixty years, the treatment of advanced prostate cancer has been based on androgen deprivation. Despite this long follow-up, the optimal treatment regimen is still a subject of controversy. Treatments inducing chemical castration have been greatly improved over recent years with the appearance of LH-RH analogues, non-steroidal antiandrogens and finally, more recently, LH-RH antagonists and Gn-RH agonists. The modalities of endocrine therapy have also evolved: early or late, total, intermittent or even targeted to the prostate by the use of non-steroidal antiandrogens alone. In this article, the authors review the results of each of these various treatment options in order to place them in perspective with the real benefit that can be expected in terms of quality of life and survival in patients with metastatic disease.