Oncological Outcomes of Hormonal Therapy with a Gonadotropin-releasing Hormone Agonist Combined with a Steroidal or Non-Steroidal Antiandrogen in Patients with Prostate Cancer

Aim: To determine the treatment outcome of combined androgen blockade (CAB) therapy using the nonsteroidal antiandrogen bicalutamide or the steroidal antiandrogen chlormadinone in patients with prostate cancer. Patients and Methods: In total, 124 patients with prostate cancer enrolled in the present study were randomized to receive CAB therapy using a gonadotropin-releasing hormone (GnRH) agonist, combined with bicalutamide or chlormadinone. The survival of patients was analyzed. Results: The 5-year cancer-specific survival for the bicalutamide- and chlormadinone-treated groups were 91.7% and 86.6%, respectively, with no significant difference (p=0.39). Five-year overall survival was significantly (p=0.029) better in the bicalutamide-treated group. Moreover, M1 patients in the chlormadinone group had significantly lower cancer-specific and overall survival compared to those in the bicalutamide-treated group. However, in the case of MO patients, no significant difference in cancer-specific nor in overall survival was observed. Conclusion: CAB therapy using chlormadinone led to a significantly poorer survival outcome versus the use of bicalutamide. However, because this survival trend was not observed in MO cases, chlormadinone may still be an option for CAB therapy, depending on clinical stage and the severity of adverse effects, such as hot flashes.