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2754056 
Journal Article 
Leuprolide versus diethylstilbestrol for metastatic prostate cancer 
Garnick, MB; Glode, LM; Smith, JA; Block, NL; Pearlman, HG; Et al 
1984 
1 
New England Journal of Medicine
ISSN: 0028-4793
EISSN: 1533-4406 
IPA/85/628057 
Engl 
REF 32 
1281-1286 
English 
IPA COPYRIGHT: ASHP A randomized prospective trial was conducted comparing the efficacy and safety of a gonadotropin-releasing hormone analog, leuprolide acetate (Lupron; I) subcutaneous injection, with those of standard therapy with oral diethylstilbestrol (DES; II) tablet as initial treatment for 199 patients with prostate cancer and stage D2 distant metastases. Initial therapy was continued for as long as an objective response was noted; crossover to the alternative arm occurred at the time of disease progression or intolerable adverse reactions. Suppression of testosterone and dihydrotestosterone and decreases in acid phosphatase were comparable in the 2 groups. Patients receiving II experienced more frequent painful gynecomastia, nausea and vomiting, edema and thromboembolism than those receiving I. The I group reported more hot flashes. Overall, 86% of the I group had an objective response, as compared with 85% of the II group. Actual survival rates at one yr were 87% for the I group and 78% for the II group. It was concluded that I offers an important alternative treatment that is therapeutically equivalent to and causes fewer side effects than II for the initial systemic management of metastatic prostate cancer.