Wilson K S, Ludgate C M, Wilson A G, Alexander A S
University of British Columbia, Vancouver, BC, Canada.
Can J Urol. 2000 Oct;7(5):1099-103.
Since a recent meta-analysis of non-steroidal anti-androgen therapy in metastatic prostate cancer concluded that survival was worse compared with medical or surgical androgen withdrawal, we analyzed our experience with flutamide monotherapy and other forms of neoadjuvant hormone therapy (NHT) prior to radiation therapy in clinically localized prostate cancer. A total of 45 patients received flutamide and 328 patients received other NHT. Flutamide patients had higher PSA levels at diagnosis and shorter duration of treatment, which could bias the results against flutamide monotherapy. Kaplan Meier analysis of PSA -- disease free survival showed significantly poorer outcome with flutamide monotherapy. Multivariate analysis supported this conclusion. Until equivalence to other forms of NHT is shown, we do not recommend flutamide monotherapy prior to radical radiation. A prospective randomized trial would be necessary to confirm this conclusion.
由于最近一项关于转移性前列腺癌非甾体类抗雄激素治疗的荟萃分析得出结论，与药物或手术去势相比，生存率更低，因此我们分析了我们在临床局限性前列腺癌放射治疗前使用氟他胺单药治疗及其他形式新辅助激素治疗（NHT）的经验。共有45例患者接受了氟他胺治疗，328例患者接受了其他NHT治疗。氟他胺治疗组患者诊断时PSA水平较高且治疗持续时间较短，这可能使结果不利于氟他胺单药治疗。对PSA-无病生存的Kaplan Meier分析显示，氟他胺单药治疗的结果明显较差。多变量分析支持这一结论。在显示与其他形式的NHT等效之前，我们不建议在根治性放疗前使用氟他胺单药治疗。需要进行一项前瞻性随机试验来证实这一结论。
