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Dr. Sophie D. Fossa from Norwegian Radium Hospital in Oslo and colleagues compared prednisone (20 mg total daily dose) with flutamide (750 mg total daily dose) in the treatment of 201 men with symptomatic, metastatic hormone-resistant prostate cancer.They found that biochemical responses, times to progression, and overall survival did not differ between the two treatments.However, quality of life scores favored prednisone therapy, which brought significantly better relief of pain, nausea and vomiting, and diarrhea, as well as better role functioning (e.g., family, work, etc.) and less appetite loss.Flutamide therapy was associated with more gastrointestinal toxicity, but the side effects were otherwise similar between the treatments.The authors recommend that prednisone monotherapy be considered as a first-line, standard, hormonal manipulation of hormone-resistant prostate cancer, but the combination with tolerable cytotoxic treatment should be explored further.*Journal of Clinical Oncology 2001;19:62-71
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