Comparison of endocrine and radiation therapy in locally advanced prostatic cancer

151 patients with locally advanced prostatic cancer (T3-4 M0), representing 38% of the 404 cancer patients in a Finnish multicenter study, were randomly assigned to one of three treatment arms: orchiectomy, estrogens or radiotherapy. During the 4-year follow-up period there were no significant differences in the progression rates (appearance of metastases in bone scan) between the therapy groups. The frequency of thromboembolic and other cardiovascular complications was highest in the estrogen group (13/50 patients). In the radiotherapy group, 19 of 45 patients had bowel or bladder complications. On the other hand, orchiectomy has few, if any, complications. The high risk of complications associated with estrogens and radiotherapy has to be taken into consideration in the selection of treatment.