[Pretreatment with chlormadinone acetate in prostate cancer patients treated with a luteinizing hormone-releasing hormone analogue].

We evaluated the efficacy of pretreatment with chlormadinone acetate (CMA) in preventing the initial testosterone surge induced by luteinizing hormone-releasing hormone (LH-RH) analogue. A total of 44 patients with previously untreated prostate cancer was included in this study. Patients were randomly assigned to 2 treatment groups: Group I-CMA therapy was begun 4 weeks before the initial LH-RH analogue injection. Group II-CMA therapy was begun 2 weeks before the initial LH-RH analogue injection. After the initial LH-RH analogue injection, CMA was administered for 12 weeks or more. After LH-RH analogue application mean values of serum luteinizing hormone (LH) and testosterone increased in both groups on day 3. However, LH and testosterone levels remained below pretreatment values in both groups. CMA pretreatment reduced the mean serum PSA. The mean relative PSA level slightly increased after administration of the LH-RH analogue in group I on day 7. In group II, the mean relative PSA level decreased after LH-RH analogue administration. Objective response rates at 12 weeks were 83.3% and 93.8% in group I and group II. Our results indicate that pretreatment with CMA for 2 weeks appeared to be sufficient to prevent the initial testosterone surge induced by LH-RH analogue.