Twenty-one of 32 patients with locally advanced
prostatic cancer (stage C) were treated with the
LH-RH analogue
Buserelin for 7-19 months. After an initial sequence of
subcutaneous injections, treatment was continued with intranasal spray application (three daily doses of 400 micrograms each) which ensured maintenance of serum
testosterone within the range seen in castrated men. To evaluate the response of the primary
tumor to
Buserelin, cytological regression was established for all patients by fine-needle aspiration biopsy every 3 months. The cytological results corresponded with those of
DNA analyses of single-cell cytophotometry showing a statistically significant drop of the grade of
aneuploidy or
polyploidy when the prostatic
carcinoma responded positively to
Buserelin therapy. Seventeen of 21 patients treated with the potent
LH-RH analogue showed good
therapy response. Four patients with no cytological signs of
tumor regression received secondary treatment with
estramustine phosphate because of
hormone resistence. One patient had to be crossed over to
cyclophosphamide, the third
drug, for
clinical progression after 15 months. Essential side effects have not been observed. Continuous treatment of locally advanced
prostatic cancer with
Buserelin, combined with close control of the patient, offers not only a real alternative to surgical
castration--as the patient is spared the psychical stress of
orchiectomy--but also to
estrogen therapy with its risk of cardiovascular side effects.