European urology supplements vol:37 issue:2 pages:128-128
EAU edition:15 location:Brussels date:12-15 April 2000
INTRODUCTION & OBJECTIVES: Most patients that undergo hormone treatment for metastatic prostate cancer die of hormone refractory disease. Chemotherapy, on a theoretically basis, could improve time to recurrence and survival. A prospective randomised trial was designed to study the impact of combined hormonal and cytotoxic treatment with Mitomycin C.
MATERIAL & METHODS: 187 patients with previously untreated histologically proven and metastatic prostate cancer were randomised for orchiectomy or orchiectomy with intravenous Mitomycin C. Cytotoxic treatment is given within 4 weeks after orchiectomy. The dosage was 50 mg/m2 every 6 weeks until unacceptable toxicity or up to a cumulative dose £ 60 mg/m2. Time to progression and survival were analysed using the Wilcoxon test. All patients have progressed and 94 % of them have died.
RESULTS: The toxicity of Mitomycin C was mainly hematologic. 10 patients stopped treatment and had to reduce dosage. In 50 % time to progression was 16 months in the Mitomycin C and 19 months in the orchiectomy group. The 50 % cancer specific survival is 27 months in the Mitomycin C and 23 months in the orchiectomy group. There is no statistically significant difference in time to progression and in cancer specific survival between both groups. The mean overall survival was 31 months in both groups.
CONCLUSIONS: Although Mitomycin C could deal with hormone resistant clones in metastatic prostate cancer its addition to conventional hormonal therapy does not improve the outcome in newly diagnosed metastatic prostate cancer patients.