Venner P
Cross Cancer Institute, Edmonton, Alta., Canada.
Oncology. 1992;49 Suppl 2:22-7. doi: 10.1159/000227123.
Although current hormonal therapy of prostate cancer may not appear to have altered survival appreciably, there have been considerable changes that may significantly affect the future management of this disease. A number of new hormonal agents have been introduced that still require definition of their therapeutic efficacy. Megestrol acetate, a hormonal agent with multiple sites of action in androgen metabolism, has recently been investigated in the treatment of patients with metastatic and locally advanced disease, and in those patients whose disease progresses with other hormonal therapies. Megestrol acetate plus mini-dose diethylstilbestrol (DES) is associated with fewer side effects than standard-dose DES and has equivalent therapeutic efficacy in the treatment of patients with metastatic disease. In patients with locally advanced disease that may benefit from hormonal cytoreduction, megestrol acetate is effective and well tolerated. Megestrol acetate has a role in the palliation of patients with progressive disease despite initial hormonal therapy. Considerable controversy surrounds the therapy of carcinoma of the prostate; further studies are required to define optimal hormonal therapy.
尽管目前前列腺癌的激素治疗似乎并未显著改变生存率，但已经出现了一些可能对该疾病未来治疗产生重大影响的显著变化。已经引入了多种新型激素药物，但其治疗效果仍有待明确。醋酸甲地孕酮是一种在雄激素代谢中具有多个作用位点的激素药物，最近已被用于研究转移性和局部晚期疾病患者以及疾病在其他激素治疗后进展的患者的治疗。与标准剂量己烯雌酚相比，醋酸甲地孕酮加小剂量己烯雌酚（DES）的副作用更少，并且在转移性疾病患者的治疗中具有同等的治疗效果。在可能从激素减瘤中获益的局部晚期疾病患者中，醋酸甲地孕酮有效且耐受性良好。尽管进行了初始激素治疗，但醋酸甲地孕酮在疾病进展患者的姑息治疗中也有作用。前列腺癌的治疗存在相当大的争议；需要进一步研究来确定最佳的激素治疗方法。
