Portal de Periódicos da CAPES

Systemic treatment for prostate cancer

1998; Elsevier BV; Volume: 24; Issue: 4 Linguagem: Inglês

10.1016/s0305-7372(98)90062-7

1532-1967

Anthony Dowling, I. F. Tannock,

Cancer, Lipids, and Metabolism

Adenocarcinoma of the prostate is the most common malignancy in men. In North America an estimated 354,300 men were diagnosed with prostate cancer in 1997 and there were about 45,000 deaths from it. (1, 2). Over 95% of primary prostate cancers are adenocarcinomas, and this overview of prostate cancer will be confined to these tumours and provides a critical review of the use of systemic therapy. Prostate cancer is a variable disease, progressing rapidly in some patients, but having an indolent course over years or decades in others. It is also confounded by the presence of other medical conditions in a population of predominantly elderly men, and from competing causes of mortality. The outcome after systemic therapies depends as much, therefore, on selection of patients as on the treatment itself. Thus claims for benefit based on small singlearm trials, or even on small randomized trials can rarely be substantiated, although they are important in generating new hypotheses. In this review we will emphasise data that have accrued from wellconducted large randomized trials.