From June 1982 to February 1985, 53 patients with stage D2 carcinoma of the prostate confirmed by tissue biopsy, elevated prostatic acid phosphatase and a positive bone scan were initiated on androgen deprivation therapy. Before commencement of treatment all patients underwent determination of serum testosterone levels at 8 a.m. Of the patients 23 received 200 mcg buserelin per day, 17 received 1 mg diethylstilbestrol 3 times daily, 6 received 40 mg megestrol acetate 4 times daily, 2 received 1 mg leuprolide per day and 5 underwent bilateral orchiectomy. Evaluation of the best response in each patient revealed 3 (6 per cent) complete and 17 (32 per cent) partial responses, while 22 patients (41 per cent) remained stable and 11 (21 per cent) had progression. Pre-treatment serum testosterone levels ranged from 150 to 879 ng per dl. The mean serum testosterone level in patients having a complete response was 524 ± 18.04 ng per dl. The mean in the progression group was 279.4 ± 110.1 ng per dl. This difference was not statistically significant owing to the large standard deviation in the progression group. However, of the 15 patients who had a pre-treatment serum testosterone level of more than 500 ng per dl only 1 (7 per cent) had progression. None of the patients whose pre-treatment testosterone level was less than 200 ng per dl had objective tumor regression. Our study suggests that pre-treatment serum testosterone levels may predict the probability of a satisfactory response to androgen deprivation therapy.
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