PMID-7624991 – Goserelin vs Orchiectomy in Advanced Prostate Cancer

PMID-7624991 – Goserelin vs Orchiectomy in Advanced Prostate Cancer

Vogelzang NJ, Chodak GW, Soloway MS, Block NL, Schellhammer PF, Smith JA Jr, Caplan RJ, Kennealey GT. Goserelin versus orchiectomy in the treatment of advanced prostate cancer: final results of a randomized trial. Urology. 1995;46(2):220-226.

Quick Reference

Property Value
PMID 7624991
DOI 10.1016/s0090-4295(99)80197-6
Year 1995
Journal Urology
Study Type RCT
Evidence Level II
Sample 283 patients with Stage D2 prostate cancer
Peptide(s) Studied Goserelin

Key Findings

  • Goserelin and orchiectomy produced similar objective response rates (82% vs 77%)
  • Median time to treatment failure was equivalent (52 vs 53 weeks)
  • Median survival was comparable (119 vs 136 weeks, not statistically different)
  • Goserelin was well tolerated as a pharmaceutical alternative to surgical castration
  • Results confirmed the equivalence of medical to surgical castration for Stage D2 disease

Study Design

Randomized, multicenter trial comparing goserelin acetate 3.6 mg SubQ depot monthly versus bilateral orchiectomy in 283 patients with Stage D2 (metastatic) prostate cancer. Primary endpoints included objective response rate, time to treatment failure, and overall survival.

Limitations

  • Open-label design
  • Stage D2 staging classification is now considered outdated
  • No quality-of-life instruments used
  • Limited to metastatic disease; does not address locally advanced cancer

Clinical Relevance

This pivotal trial helped establish goserelin as a standard alternative to surgical castration for metastatic prostate cancer. By demonstrating equivalent efficacy with a reversible, non-surgical approach, it contributed to the widespread adoption of GnRH agonist therapy as first-line androgen deprivation treatment, offering patients a less invasive option with equivalent oncologic outcomes.

Related

#research #RCT #peptide #sexual-health #evidence-level-II