Tsukamoto S, Akaza H
Department of Urology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.
Gan To Kagaku Ryoho. 2001 Jul;28(7):917-26.
We offer a historical overview of endocrine therapy for prostate cancer. Hormone therapy remains the cornerstone of treatment for patients with locally advanced or metastatic prostate cancer. Although this therapy has been traditionally performed by oral estrogen or bilateral orchiectomy, there are now two most important pharmacological hormonal therapies: LH-RH agonist and antiandrogen therapy. We do not have yet sufficient data to conclude whether maximal androgen blockade from the combined use of an LH-RH agonist and an antiandrogen will prolong the survival in patients with metastatic prostate cancer, nor to conclude whether neoadjuvant androgen ablation therapy improves the disease-free survival of patients after radical prostatectomy. New treatment strategies and modalities such as LH-RH antagonists, intermittent hormonal therapy, and antiandrogen monotherapy are appearing and being tested in clinical trials. However, to date there is still no effective therapy for patients who have hormone refractory disease.
我们提供了前列腺癌内分泌治疗的历史概述。激素疗法仍然是局部晚期或转移性前列腺癌患者治疗的基石。尽管传统上这种治疗是通过口服雌激素或双侧睾丸切除术进行的,但现在有两种最重要的药物激素疗法:促黄体生成素释放激素(LH-RH)激动剂和抗雄激素疗法。我们尚无足够数据来确定联合使用LH-RH激动剂和抗雄激素进行最大雄激素阻断是否会延长转移性前列腺癌患者的生存期,也无法确定新辅助雄激素消融疗法是否能改善根治性前列腺切除术后患者的无病生存期。诸如LH-RH拮抗剂、间歇性激素疗法和抗雄激素单一疗法等新的治疗策略和方式正在出现,并正在临床试验中进行测试。然而,迄今为止,对于患有激素难治性疾病的患者仍然没有有效的治疗方法。