A Comparison of Estramustine Phosphate and Streptozotocin in Patients with Advanced Prostatic Carcinoma Who Have Had Extensive Irradiation

Abstract

No AccessJournal of Urology1 Aug 1977A Comparison of Estramustine Phosphate and Streptozotocin in Patients with Advanced Prostatic Carcinoma Who Have Had Extensive Irradiation Gerald P. Murphy, Robert P. Gibbons, Douglas E. Johnson, Stefan A. Loening, George R. Prout, Joseph D. Schmidt, Dean S. Bross, T. Ming Chu, John F. Gaeta, Jack Saroff, and William W. Scott Gerald P. MurphyGerald P. Murphy More articles by this author , Robert P. GibbonsRobert P. Gibbons More articles by this author , Douglas E. JohnsonDouglas E. Johnson More articles by this author , Stefan A. LoeningStefan A. Loening More articles by this author , George R. ProutGeorge R. Prout More articles by this author , Joseph D. SchmidtJoseph D. Schmidt More articles by this author , Dean S. BrossDean S. Bross More articles by this author , T. Ming ChuT. Ming Chu More articles by this author , John F. GaetaJohn F. Gaeta More articles by this author , Jack SaroffJack Saroff More articles by this author , and William W. ScottWilliam W. Scott More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)57975-6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail In this second nationally randomized cooperative chemotherapy trial of the National Prostatic Cancer Project 125 patients with histologically confirmed progressing advanced carcinoma of the prostate (clinical stage D) who had had prior pelvic irradiation of at least 2,000R received as initial therapy 1 of 2 non-myelosuppressive agents—estramustine phosphate or streptozotocin—for comparison with patients randomized to receive standard treatment. Patients whose disease was progressive after 12 weeks on chemotherapy were crossed over to receive the alternate therapeutic agent. Response to treatment was evaluated in 105 patients on the basis of previously established and defined criteria. All known prognostic factors were comparable among the 3 treatment arms. The objective response rates to therapy were 19 per cent in the standard arm (stable only), 30 per cent in the estramustine phosphate arm (stable and partial regression) and 32 per cent in the streptozotocin arm (stable arm). Thus far, 4 patients crossed to estramustine phosphate and 2 patients crossed to streptozotocin responded to therapy. In a number of response parameters estramustine phosphate had an advantage over the other 2 treatment arms. Nausea and vomiting were the predominant toxicities for patients in all treatment arms. Average survival time is longer for patients receiving the chemotherapies. Estramustine phosphate seems to be the superior drug and both chemotherapies are superior to standard treatment. A significant number of patients are still being treated actively and followed, and their responses will affect the final conclusions only more favorably. © 1977 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byWhite R, Romas N, Tomashefsky P, Hall E and Olsson C (2018) Misonidazole as a Chemosensitizer in the Treatment of the Dunning Prostate Cancer ModelJournal of Urology, VOL. 131, NO. 2, (374-377), Online publication date: 1-Feb-1984.Soloway M, Beckley S, Brady M, Chu T, Dekernion J, Dhabuwala C, Gaeta J, Gibbons R, Loening S, Mckiel C, Mcleod D, Pontes J, Prout G, Scardino P, Schlegel J, Schmidt J, Scott W, Slack N and Murphy G (2018) A Comparison of Estramustine Phosphate Versus Cis-platinum Alone Versus Estramustine Phosphate Plus Cis-platinum in Patients with Advanced Hormone Refractory Prostate Cancer Who Had Had Extensive Irradiation to the Pelvis or Lumbosacral AreaJournal of Urology, VOL. 129, NO. 1, (56-61), Online publication date: 1-Jan-1983.Loening S, Beckle S, Brady M, Chu T, Dekernion J, Dhabuwala C, Gaeta J, Gibbons R, Mckiel C, McLeod D, Pontes J, Prout G, Scardino P, Schlegel J, Schmidt J, Scott W, Slack N, Soloway M and Murphy G (2018) Comparison of Estramustine Phosphate, Methotrexate and cis-Platinum: in Patients with Advanced1 Hormone Refractory Prostate CancerJournal of Urology, VOL. 129, NO. 5, (1001-1006), Online publication date: 1-May-1983.Paulson D (2018) Editorial CommentJournal of Urology, VOL. 129, NO. 5, (1006-1006), Online publication date: 1-May-1983.Soloway M, deKernion J, Gibbons R, Johnson D, Loening S, Pontes J, Prout G, Schmidt J, Scott W, Chu T, Gaeta J, Slack N and Murphy G (2018) Comparison of Estramustine Phosphate and Vincristine Alone or in Combination for Patients with Advanced, Hormone Refractory, Previously Irradiated Carcinoma of the ProstateJournal of Urology, VOL. 125, NO. 5, (664-667), Online publication date: 1-May-1981.Schmidt J (2018) Chemotherapy of Hormone-Resistant Stage D Prostatic CancerJournal of Urology, VOL. 123, NO. 6, (797-805), Online publication date: 1-Jun-1980.Schmidt J, Scott W, Gibbons R, Johnson D, Prout G, Loening S, Soloway M, Chu T, Gaeta J, Slack N, Saroff J and Murphy G (2018) Comparison of Procarbazine, Imidazole-Carboxamide and Cyclophosphamide in Relapsing Patients with Advanced Carcinoma of the ProstateJournal of Urology, VOL. 121, NO. 2, (185-189), Online publication date: 1-Feb-1979. Volume 118Issue 2August 1977Page: 288-291 Advertisement Copyright & Permissions© 1977 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Gerald P. Murphy More articles by this author Robert P. Gibbons More articles by this author Douglas E. Johnson More articles by this author Stefan A. Loening More articles by this author George R. Prout More articles by this author Joseph D. Schmidt More articles by this author Dean S. Bross More articles by this author T. Ming Chu More articles by this author John F. Gaeta More articles by this author Jack Saroff More articles by this author William W. Scott More articles by this author Expand All Advertisement PDF downloadLoading ...