The European Organization for Research and Treatment of Cancer randomized 201 patients to either prednisolone 5 milligrams four times per day or flutamide 250 milligrams three times per day following symptomatic progression of prostate cancer treated with initial medical or surgical castration.140 The investigators concluded that treatment with prednisolone or flu-tamide leads to similar rates of progression and overall survival and no difference in subjective or biochemical response. A U.S. National Prostatic Cancer Project trial randomized 220 men with hormone-refractory prostate cancer after initial surgical castration to either flutamide or estramustine therapy and found no difference in response or survival between the two drugs.141
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