Rübben H
Urologische Klinik und Poliklinik, Medizinische Einrichtungen der Universität GHS Essen.
Praxis (Bern 1994). 2001 Sep 20;90(38):1641-4.
Hormonal treatment is a androgenoprive therapy. Adjuvant treatment after radical prostatectomy or radiotherapy seems to have no survival benefit. Neoadjuvant hormonal treatment before local therapy has no proven survival benefit. Hormonal treatment in metastatic disease can be initiated immediately, deferred or intermittent. Androgen-deprivation is performed by castration or LHRH-analoga and/or anti-androgens. Maximal androgen-deprivation has significant more side effect and is of only limited survival bebefit for a subgroup of patients. The onset of hormonal treatment is under discussion. An increase of PSA (> 25 ng/ml) and/or occurrence of symptoms is an indication for hormonal treatment. Intermittent androgen-deprivation is under investigation as a new concept.
激素治疗是一种雄激素剥夺疗法。前列腺癌根治术或放疗后的辅助治疗似乎没有生存获益。局部治疗前的新辅助激素治疗尚无经证实的生存获益。转移性疾病的激素治疗可以立即开始、推迟或间歇进行。雄激素剥夺通过去势或促性腺激素释放激素类似物(LHRH-analoga)和/或抗雄激素药物来实现。最大程度的雄激素剥夺有更多显著的副作用,并且仅对一小部分患者有有限的生存益处。激素治疗的开始时机存在争议。前列腺特异性抗原(PSA)升高(>25 ng/ml)和/或出现症状是激素治疗的指征。间歇性雄激素剥夺作为一个新概念正在研究中。