Furuya Yuzo, Nozaki Tetsuo, Nagakawa Osamu, Fuse Hideki
Department of Urology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Endocr J. 2002 Feb;49(1):85-90. doi: 10.1507/endocrj.49.85.
Patients with prostate cancer generally respond to androgen withdrawal therapy, but progression to androgen-independence is frequently observed later. To examine whether pretreatment serum androgen status could predict disease progression in metastatic prostate cancer, pretreatment serum testosterone, histological grade, extent of bony metastasis, serum prostate-specific antigen (PSA) response to hormone therapy, and prognosis of the 40 patients with untreated metastatic prostate cancer who received endocrine therapy were evaluated. Although there were no differences in age, pretreatment PSA level, extent of bony disease and histological grade between patients with normal testosterone and those with low testosterone, PSA response after endocrine therapy was better in normal testosterone group. There was a significantly longer interval to disease progression in patients with normal testosterone than in those with low testosterone. The patients with metastatic prostate cancer with low serum testosterone were in the high risk group of worse response to endocrine therapy. Additional therapy might be considered in those patients.
前列腺癌患者通常对雄激素剥夺疗法有反应，但随后经常会出现向雄激素非依赖性进展的情况。为了研究治疗前血清雄激素状态是否可以预测转移性前列腺癌的疾病进展，对40例接受内分泌治疗的未经治疗的转移性前列腺癌患者的治疗前血清睾酮、组织学分级、骨转移范围、血清前列腺特异性抗原（PSA）对激素治疗的反应以及预后进行了评估。尽管睾酮水平正常的患者与睾酮水平低的患者在年龄、治疗前PSA水平、骨病范围和组织学分级方面没有差异，但内分泌治疗后PSA反应在睾酮水平正常组中更好。睾酮水平正常的患者疾病进展间隔时间明显长于睾酮水平低的患者。血清睾酮水平低的转移性前列腺癌患者处于内分泌治疗反应较差的高风险组。对于这些患者可能需要考虑额外的治疗。
