Gates G A, Rice D H, Koopmann C F, Schuller D E
Department of Otolaryngology, Washington University School of Medicine, St. Louis, MO 63110.
Laryngoscope. 1992 Jun;102(6):641-4. doi: 10.1288/00005537-199206000-00009.
Juvenile nasopharyngeal angiofibroma (JNA) appears to be an endocrine-responsive tumor. This concept was tested in five young men with JNA by treating them with a testosterone receptor blocker (flutamide) for 6 weeks preoperatively. Tumor size was evaluated by axial computed tomography both before and after flutamide therapy. Four of the five patients had an average tumor shrinkage of 44%. The patients tolerated the drug well, and the serum testosterone levels 2 or more years posttherapy were normal. This pilot study demonstrate that preoperative hormonal pharmacoreduction of JNA is a feasible adjunct to surgical therapy that offers the possibility of reduced blood loss. However, the authors believe that a formal clinical trial of this treatment approach is warranted and should be done before widespread adoption of this agent.
青少年鼻咽血管纤维瘤（JNA）似乎是一种对内分泌有反应的肿瘤。通过在术前用睾酮受体阻滞剂（氟他胺）对5名患有JNA的年轻男性进行6周治疗，对这一概念进行了验证。在氟他胺治疗前后均通过轴向计算机断层扫描评估肿瘤大小。5名患者中有4名的肿瘤平均缩小了44%。患者对该药物耐受性良好，治疗后2年或更长时间的血清睾酮水平正常。这项初步研究表明，JNA术前激素药物减量是手术治疗的一种可行辅助手段，有可能减少失血。然而，作者认为这种治疗方法的正式临床试验是必要的，并且应该在广泛采用这种药物之前进行。
