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Published on: March 6, 2018
[Clinical study of diethylstilbestrol in hormone refractory prostate cancer]
Jian-wei Wang1, Li-qun Zhou, Shi-qi Ji
1Department of Urology, Peking University First Hospital, Beijing, China.
Objective:
To summarize the clinical outcome and adverse events of estrogen therapy for hormone refractory prostate cancer.
Methods:
A total of 32 patients with hormone refractory prostate cancer received diethylstilbestrol (DES) 2 mg daily at our institute. The data of PSA (prostate-specific antigen) change, time to progression, overall survival rate, disease-specific survival rate and adverse events were collected and analyzed.
Results:
The data of 29 patients were complete. The mean duration of DES dosing was 8.6 ± 0.9 months. Among them, 8 (27.5%) patients achieved a PSA response with a 50% decrement of PSA or more. Seven (24.1%) patients had a stable level of PSA (50% < PSA < 125%) while 14 of 29 (48.3%) maintained a PSA progression with a 25% increment of PSA or more. The overall median time to progression was 4 (1 - 12) months. And the median time to progression was 6 (5-12) months in the PSA response group. The overall survival rate was 48.3% and disease-specific survival rate 55.2%. The main adverse events were gynecomastia (10/29, 34.5%) and deep vein thrombosis (3/29, 10.3%).
Conclusion:
When used for the treatment of hormone refractory prostate cancer, diethylstilbestrol at a daily dose of 2 mg can achieve a PSA response in 27.5% patients and a PSA stability in 24.1% patients. And the median time to progression is 4 months. Estrogen is efficacious for the patients with hormone refractory prostate cancer.
Insights
Estrogen therapy using diethylstilbestrol (DES) showed efficacy in hormone-refractory prostate cancer, with over 50% of patients achieving PSA response or stability. Key adverse events included gynecomastia and deep vein thrombosis.
Area of Science:
- Oncology
- Endocrinology
Context:
- Hormone-refractory prostate cancer (HRPC) presents a significant clinical challenge.
- Estrogen therapy has been explored as a treatment option for HRPC.
Purpose:
- To evaluate the clinical outcomes and adverse events of estrogen therapy in patients with HRPC.
Summary:
- A study of 32 HRPC patients treated with diethylstilbestrol (DES) 2 mg daily revealed a 27.5% PSA response rate and 24.1% PSA stability.
- Median time to progression was 4 months, with an overall survival rate of 48.3%.
- Common adverse events were gynecomastia (34.5%) and deep vein thrombosis (10.3%).
Impact:
- Diethylstilbestrol (DES) demonstrates efficacy in managing hormone-refractory prostate cancer.
- Estrogen therapy offers a viable treatment option for HRPC, warranting further investigation into its risk-benefit profile.
