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Eligibility Criteria

.Main entry criteria:

Patients must fulfil one of the criteria in section 1 or one of the criteria in section 2. Additionally, all patients must fulfil the criteria in section 3.

Section 1: High Risk Newly Diagnosed Patients

…with one of:-

(i) Fulfil at least two out of the three following criteria, Stage T3/4 N0 M0 histologically confirmed prostate adenocarcinoma, PSA ≥40ng/ml or Gleason sum score 8-10

(ii) Stage Tany N+ M0 or Tany Nany M+ histologically confirmed prostate adenocarcinoma

(iii) Multiple sclerotic bone metastases with a PSA ≥100ng/ml without histological confirmation

OR

Section 2: Patients with histologically confirmed prostate adenocarcinoma previously treated with radical surgery or radiotherapy who are now relapsing

…with at least one of:-

(i) PSA ≥4ng/ml and rising with doubling time less than 6 months

(ii) PSA ≥20ng/ml

(iii) N+ and/or  M+

Note: Prior hormone therapy for localised disease must have been completed at least 12 months previously and have been no longer than 12 months in duration. It can have been given as adjuvant or neoadjuvant therapy.

AND

Section 3: For all patients:-

(i) Intention to treat with long-term hormone therapy

(ii) Fit for all protocol treatment and follow-up, WHO performance status 0-2

(iii) Have completed the appropriate investigations prior to randomisation

(iv) Adequate haematological function: neutrophil count ≥1.5x109/l and platelets ≥100x109/l

(v) Adequate renal function: Serum creatinine ≤1.5 ULN

(vi) Adequate liver function: ALT or AST ≤1.5 ULN, bilirubin ≤ ULN

(vii) Written informed consent

(viii) Willing and expected to comply with follow-up schedule