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dc.contributor.authorWilkins, A
dc.contributor.authorShahidi, M
dc.contributor.authorParker, C
dc.contributor.authorGunapala, R
dc.contributor.authorThomas, K
dc.contributor.authorHuddart, R
dc.contributor.authorHorwich, A
dc.contributor.authorDearnaley, D
dc.date.accessioned2018-07-23T15:18:29Z
dc.date.issued2012-12
dc.identifier.citationBJU international, 2012, 110 (11 Pt B), pp. E727 - E735
dc.identifier.issn1464-4096
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/2122
dc.identifier.eissn1464-410X
dc.identifier.doi10.1111/j.1464-410x.2012.11546.x
dc.description.abstractUnlabelled What's known on the subject? and What does the study add? Diethylstilbestrol (DES) was the first hormone treatment used for prostate cancer and has also shown effectiveness in castration-resistant disease in small studies; however, concerns over thromboembolic toxicity have restricted its use in the past. Over 200 elderly men with castration-resistant prostate cancer were treated with 1-3 mg of DES, given with 75 mg aspirin and breast bud irradiation. Almost 30% of men showed a significant PSA response and the median time to PSA progression was 4.6 months. Almost 20% of patients with pain had a significant analgesic benefit. The most important toxicity was thromboembolism in 10% of men. Overall the drug has an acceptable toxicity profile and offers a palliative benefit in frail elderly men who may not be fit for chemotherapy.Objective • To assess the efficacy and toxicity of diethylstilbestrol (DES) in the management of castration-resistant prostate cancer (CRPC).Patients and methods • A total of 231 patients with CRPC received treatment with DES at the Royal Marsden Hospital between August 1992 and August 2000. • The median pre-treatment prostate-specific antigen (PSA) level was 221 ng/mL. • DES was used at a dose of 1-3 mg daily, with aspirin 75 mg. • The primary endpoint was PSA response rate.Results • The PSA response rate (using PSA Working Group criteria) was 28.9%. • The median time to PSA progression was 4.6 months. • Of patients with bone pain, 18% had an improvement in their European Organisation for the Research and Treatment of Cancer pain score. • Thromboembolic complications were seen in 9.9% of all patients.Conclusions • DES has significant activity in CRPC and can be of palliative benefit. • DES has an acceptable toxicity profile in the management of patients with symptomatic CRPC when used at a dose of 1-3 mg, combined with aspirin and prophylactic breast bud radiotherapy.
dc.formatPrint-Electronic
dc.format.extentE727 - E735
dc.languageeng
dc.language.isoeng
dc.subjectHumans
dc.subjectProstatic Neoplasms
dc.subjectDisease Progression
dc.subjectDiethylstilbestrol
dc.subjectProstate-Specific Antigen
dc.subjectEstrogens, Non-Steroidal
dc.subjectTreatment Outcome
dc.subjectOrchiectomy
dc.subjectFollow-Up Studies
dc.subjectProspective Studies
dc.subjectAged
dc.subjectMale
dc.titleDiethylstilbestrol in castration-resistant prostate cancer.
dc.typeJournal Article
rioxxterms.versionofrecord10.1111/j.1464-410x.2012.11546.x
rioxxterms.licenseref.startdate2012-12
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfBJU international
pubs.issue11 Pt B
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume110
pubs.embargo.termsNot known
icr.researchteamClinical Academic Radiotherapy (Dearnaley)en_US
icr.researchteamClinical Academic Radiotherapy (Huddart)en_US
icr.researchteamTargeted Therapyen_US
dc.contributor.icrauthorHorwich, Alanen
dc.contributor.icrauthorDearnaley, Daviden
dc.contributor.icrauthorHuddart, Roberten
dc.contributor.icrauthorParker, Chrisen
dc.contributor.icrauthorCorbett, Annaen


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