Department of Urology, Walter Reed Army Medical Center, Washington, D.C.
The National Prostatic Cancer Project from 1982 to 1985 evaluated several treatments for metastatic prostatic cancer patients who had a history of prior radiotherapy and were refractory to hormone manipulation. The treatments studied were megestrol acetate (Megace), Megace plus diethylstilbestrol (DES), diethylstilbestrol diphosphate (Stilphostrol), and streptozotocin. While the four treatment arms did not differ significantly with respect to survival, there was a small but significant difference in progression-free survival among the treatment groups. These patients are difficult to treat and have many secondary problems, and perhaps future studies of current and new agents should focus more on subjective and other secondary benefits for them.