Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot2 - STU 1 ballot
Evidence Based Medicine on FHIR Implementation Guide
1.0.0-ballot2 - STU 1 ballot
This page is part of the Evidence Based Medicine on FHIR Implementation Guide (v1.0.0-ballot2: STU1 Ballot 2) based on FHIR (HL7® FHIR® Standard) v6.0.0. No current official version has been published yet. For a full list of available versions, see the Directory of published versions
| Page standards status: Informative |
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Citation 179628</b></p><a name=\"179628\"> </a><a name=\"hc179628\"> </a><a name=\"179628-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: 9; Last updated: 2025-03-27 12:20:19+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-journal-article-citation.html\">JournalArticleCitation</a></p></div><p><b>url</b>: <a href=\"Citation-179628.html\">Citation 14706014 Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.</a></p><p><b>identifier</b>: FEvIR Object Identifier/https://fevir.net/FOI/179628, <code>https://pubmed.ncbi.nlm.nih.gov</code>/14706014, <a href=\"http://terminology.hl7.org/6.2.0/NamingSystem-uri.html\" title=\"As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt \r\n\r\nThis oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: \r\n\r\nNote that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.\r\n\r\nThis OID may also be used in CD.codeSystem.\">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.44.15.16</p><p><b>version</b>: 1.0.0-ballot2</p><p><b>title</b>: 14706014 Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.</p><p><b>status</b>: Active</p><p><b>date</b>: 2025-03-28 17:11:38+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href=\"http://www.hl7.org/Special/committees/dss\">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: </p><div><p>This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p>\n</div><h3>UseContexts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"http://hl7.org/fhir/R5/codesystem-citation-classification-type.html#citation-classification-type-fevir-platform-use\">Citation Classification Type fevir-platform-use</a>: FEvIR Platform Use</td><td><span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier medline-base}\">Medline Base</span></td></tr></table><p><b>jurisdiction</b>: <span title=\"Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}\">World</span></p><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>\n</div><p><b>approvalDate</b>: 2004-06-15</p><p><b>lastReviewDate</b>: 2019-09-22</p><p><b>author</b>: Computable Publishing®: MEDLINE-to-FEvIR Converter: </p><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-classification-type citation-source}\">Citation Source</span></p><p><b>classifier</b>: <span title=\"Codes:\">MEDLINE</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-classification-type medline-owner}\">MEDLINE Citation Owner</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#owner_value NLM}\">National Library of Medicine, Index Section</span></p></blockquote><p><b>currentState</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-status-type medline-medline}\">Medline Citation Status of Medline</span>, <span title=\"Codes:{http://hl7.org/fhir/citation-status-type pubmed-publication-status-ppublish}\">PubMed PublicationStatus of ppublish</span></p><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-pubmed}\">PubMed Pubstatus of Pubmed</span></p><p><b>period</b>: ?? --> 2004-01-07 05:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-medline}\">PubMed Pubstatus of Medline</span></p><p><b>period</b>: ?? --> 2004-06-16 05:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-entrez}\">PubMed Pubstatus of Entrez</span></p><p><b>period</b>: ?? --> 2004-01-07 05:00:00+0000</p></blockquote><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: <code>https://pubmed.ncbi.nlm.nih.gov</code>/14706014, <code>https://doi.org</code>/10.1111/j.1442-2042.2004.t01-1-00748.x, pii/748</p><h3>Titles</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Language</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/title-type primary}\">Primary title</span></td><td><span title=\"Codes:{urn:ietf:bcp:47 en}\">English</span></td><td><div><p>Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.</p>\n</div></td></tr></table><h3>Abstracts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/cited-artifact-abstract-type primary-human-use}\">Primary human use</span></td><td><div><p><strong>BACKGROUND:</strong> The present study was undertaken mainly to investigate whether chemohormonal therapy with estramustine phosphate plus luteinizing hormone-releasing hormone (LHRH) agonist has a more beneficial effect than the hormonal therapy with flutamide plus LHRH agonist for newly diagnosed patients with metastatic prostate cancer.\n<strong>METHODS:</strong> A total of 57 patients with metastatic prostate cancer aged 59-80 years (median 74 years) were entered in the study and were randomized to the treatment of estramustine phosphate (560 mg/day) plus LHRH agonist (estramustine group) or flutamide (375 mg/day) plus LHRH agonist (flutamide group) with stratification for the degree of performance status, histological differentiation and bone metastasis.\n<strong>RESULTS:</strong> Both of the treatment regimens were well tolerated with similar incidences of adverse drug reactions. The overall response rates (complete response plus partial response) at 12 weeks after treatment in the estramustine and flutamide groups were 76 and 55%, respectively. The median time to objective progression for the estramustine group (25.4 months) was longer than that of the flutamide group (14.6 months). The serum levels of follicle stimulating hormone and testosterone were significantly lower in the estramustine group.\n<strong>CONCLUSIONS:</strong> Chemohormonal therapy with estramustine phosphate plus LHRH agonist showed longer clinical progression-free survival than the hormonal therapy with flutamide plus LHRH agonist (P = 0.03), although there was no significant difference in the overall survival. A larger-scaled trial with more statistical power is required to clarify that the former regimen is more beneficial than the latter for newly diagnosed patients with advanced prostate cancer.</p>\n</div></td></tr></table><blockquote><p><b>publicationForm</b></p><blockquote><p><b>publishedIn</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/published-in-type D020492}\">Periodical</span></p><p><b>identifier</b>: Print ISSN Type/0919-8172, ISOAbbreviation/Int J Urol, ISSN Linking/0919-8172, Medline Title Abbreviation/Int J Urol, NLM Unique ID/9440237</p><p><b>title</b>: International journal of urology : official journal of the Japanese Urological Association</p><p><b>publisherLocation</b>: Australia</p></blockquote><p><b>citedMedium</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-medium print}\">Print</span></p><p><b>volume</b>: 11</p><p><b>issue</b>: 2</p><p><b>articleDate</b>: 2004-02</p><p><b>publicationDateText</b>: 2004-Feb</p><p><b>pageString</b>: 103-9</p></blockquote><h3>WebLocations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Classifier</b></td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/artifact-url-classifier abstract}\">Abstract</span></td><td><a href=\"https://pubmed.ncbi.nlm.nih.gov/14706014/\">https://pubmed.ncbi.nlm.nih.gov/14706014/</a></td></tr></table><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type publishing-model}\">Publishing Model</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier Print}\">Print</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type chemical}\">Chemical</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D000726}\">Androgen Antagonists</span>, <span title=\"Codes:{https://www.nlm.nih.gov/mesh D018931}\">Antineoplastic Agents, Hormonal</span>, <span title=\"Codes:{https://www.cas.org/support/documentation/chemical-substances 33515-09-2}, {https://www.nlm.nih.gov/mesh D007987}\">Gonadotropin-Releasing Hormone</span>, <span title=\"Codes:{https://www.cas.org/support/documentation/chemical-substances 35LT29625A}, {https://www.nlm.nih.gov/mesh D004961}\">Estramustine</span>, <span title=\"Codes:{https://www.cas.org/support/documentation/chemical-substances 76W6J0943E}, {https://www.nlm.nih.gov/mesh D005485}\">Flutamide</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">MeSH heading</span></p><p><b>artifactAssessment</b>: <a href=\"#hc179628/meshHeading0\">ArtifactAssessment: artifact[x] = this resource</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type publication-type}\">Publication type</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D016430}\">Clinical Trial</span>, <span title=\"Codes:{https://www.nlm.nih.gov/mesh D016428}\">Journal Article</span>, <span title=\"Codes:{https://www.nlm.nih.gov/mesh D016449}\">Randomized Controlled Trial</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type knowledge-artifact-type}\">Knowledge Artifact Type</span></p><p><b>classifier</b>: <span title=\"Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}\">Journal Article</span></p><p><b>artifactAssessment</b>: Classifier added by Computable Publishing LLC</p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type citation-subset}\">Citation subset</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#citationsubset IM}\">IM</span></p></blockquote><blockquote><p><b>contributorship</b></p><p><b>complete</b>: true</p><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc179628/contributor0\">Noguchi M</a></p><p><b>forenameInitials</b>: M</p><p><b>affiliation</b>: Department of Urology, Kurume University School of Medicine, Kurume, Japan. noguchi@med.kurume-u.ac.jp</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc179628/contributor1\">Noda S</a></p><p><b>forenameInitials</b>: S</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc179628/contributor2\">Yoshida M</a></p><p><b>forenameInitials</b>: M</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc179628/contributor3\">Ueda S</a></p><p><b>forenameInitials</b>: S</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc179628/contributor4\">Shiraishi T</a></p><p><b>forenameInitials</b>: T</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc179628/contributor5\">Itoh K</a></p><p><b>forenameInitials</b>: K</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href=\"#hc179628/contributor6\">Kurume-Kumamoto Estracyt Study Group</a></p></blockquote></blockquote></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner #contributor0</b></p><a name=\"179628/contributor0\"> </a><a name=\"hc179628/contributor0\"> </a><a name=\"179628/contributor0-en-US\"> </a><p><b>name</b>: Masanori Noguchi </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner #contributor1</b></p><a name=\"179628/contributor1\"> </a><a name=\"hc179628/contributor1\"> </a><a name=\"179628/contributor1-en-US\"> </a><p><b>name</b>: Shinshi Noda </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner #contributor2</b></p><a name=\"179628/contributor2\"> </a><a name=\"hc179628/contributor2\"> </a><a name=\"179628/contributor2-en-US\"> </a><p><b>name</b>: Masaki Yoshida </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner #contributor3</b></p><a name=\"179628/contributor3\"> </a><a name=\"hc179628/contributor3\"> </a><a name=\"179628/contributor3-en-US\"> </a><p><b>name</b>: Shoichi Ueda </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner #contributor4</b></p><a name=\"179628/contributor4\"> </a><a name=\"hc179628/contributor4\"> </a><a name=\"179628/contributor4-en-US\"> </a><p><b>name</b>: Taizo Shiraishi </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Practitioner #contributor5</b></p><a name=\"179628/contributor5\"> </a><a name=\"hc179628/contributor5\"> </a><a name=\"179628/contributor5-en-US\"> </a><p><b>name</b>: Kyogo Itoh </p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: Organization #contributor6</b></p><a name=\"179628/contributor6\"> </a><a name=\"hc179628/contributor6\"> </a><a name=\"179628/contributor6-en-US\"> </a><p><b>name</b>: Kurume-Kumamoto Estracyt Study Group</p></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: ArtifactAssessment #meshHeading0</b></p><a name=\"179628/meshHeading0\"> </a><a name=\"hc179628/meshHeading0\"> </a><a name=\"179628/meshHeading0-en-US\"> </a><p><b>artifact</b>: <a href=\"#hc179628\">Citation 14706014 Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.</a></p><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D000368}\">Aged</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D000369}\">Aged, 80 and over</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D000726}\">Androgen Antagonists</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh Q000008}\">administration & dosage</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}\">Yes</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D018931}\">Antineoplastic Agents, Hormonal</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh Q000008}\">administration & dosage</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">is Major topic</span></td><td><span title=\"Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}\">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D018572}\">Disease-Free Survival</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D004305}\">Dose-Response Relationship, Drug</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D004334}\">Drug Administration Schedule</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D004359}\">Drug Therapy, Combination</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">qualifier</span></td><td><span title=\"Codes:\">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}\">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh D004961}\">Estramustine</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:\">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title=\"Codes:\">qualifier</span></p><p><b>classifier</b>: <span title=\"Codes:{https://www.nlm.nih.gov/mesh Q000008}\">administration & dosage</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td 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"text" : "**BACKGROUND:** The present study was undertaken mainly to investigate whether chemohormonal therapy with estramustine phosphate plus luteinizing hormone-releasing hormone (LHRH) agonist has a more beneficial effect than the hormonal therapy with flutamide plus LHRH agonist for newly diagnosed patients with metastatic prostate cancer.\n**METHODS:** A total of 57 patients with metastatic prostate cancer aged 59-80 years (median 74 years) were entered in the study and were randomized to the treatment of estramustine phosphate (560 mg/day) plus LHRH agonist (estramustine group) or flutamide (375 mg/day) plus LHRH agonist (flutamide group) with stratification for the degree of performance status, histological differentiation and bone metastasis.\n**RESULTS:** Both of the treatment regimens were well tolerated with similar incidences of adverse drug reactions. The overall response rates (complete response plus partial response) at 12 weeks after treatment in the estramustine and flutamide groups were 76 and 55%, respectively. The median time to objective progression for the estramustine group (25.4 months) was longer than that of the flutamide group (14.6 months). The serum levels of follicle stimulating hormone and testosterone were significantly lower in the estramustine group.\n**CONCLUSIONS:** Chemohormonal therapy with estramustine phosphate plus LHRH agonist showed longer clinical progression-free survival than the hormonal therapy with flutamide plus LHRH agonist (P = 0.03), although there was no significant difference in the overall survival. A larger-scaled trial with more statistical power is required to clarify that the former regimen is more beneficial than the latter for newly diagnosed patients with advanced prostate cancer."
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