Efficacy of Bicalutamide Monotherapy in Locally Advanced Prostate Cancer

Koh, Jun Sung; Lee, Chung Bum; Suh, Hong Jin; Lee, Yoon Bo; Cho, Dae Haeng; Lee, Ji Youl

Abstract

PURPOSE: Nonsteroidal antiandrogen monotherapy may be a treatment option for some patients with locally advanced prostate cancer. We report the efficacy, advantage, and adverse events of bicalutamide monotherapy in patients with locally advanced prostate cancer.
MATERIALS AND METHODS
We retrospectively reviewed 13 patients with locally advanced prostate cancer who were treated with bicalutamide 150mg monotherapy. Serum PSA reduction was evaluated with periodic PSA follow-ups. If clinical progression was suspected, pelvic CT or bone scan was performed for the evaluation of disease progression. The changes of sexual function were assessed with the IIEF questionnaires prior to treatment and after 6 months of medication.
RESULTS
Serum PSA declined to less than 2ng/ml within 3 months after treatment in most patients. A high serum PSA level was maintained in only 1 patient, and this patient showed disease progression. There were no significant differences between the mean scores of the pretreatment and post-treatment erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction (p>0.05). Of the 13 patients, 2 patients (15.5%) showed adverse events, such as breast pain and gynecomastia. However, the symptoms were mild to moderate. There was no withdrawal to medication due to drug-related adverse events.
CONCLUSIONS
From the viewpoint of the fall in serum PSA levels after 3 months, bicalutamide monotherapy was effective in the treatment of locally advanced prostate cancer. There were benefits to the patients in terms of the quality of life parameters, sexual function, and tolerability, which make bicalutamide monotherapy an attractive treatment option for patients with locally advanced prostate cancer. (Korean J Urol 2004;45: 108-113)