Gillessen S, Strasser F
Onkologie/Hämatologie/Palliativmedizin, Kantonsspital, St. Gallen.
Ther Umsch. 2006 Feb;63(2):157-62. doi: 10.1024/0040-5930.63.2.157.
Prostate cancer is the second leading cause of cancer-related death in Switzerland as well as in other western countries. For patients with advanced disease, ablation of androgens is regarded as optimal first-line treatment. But this treatment is palliative with a median duration of response of about 18 months and hormone refractory prostate cancer remains a challenge. Last year, two large randomised trials demonstrated for the first time a survival benefit with docetaxel based therapy. Additionally, because of better understanding of the biology of hormone refractory prostate cancer a number of new systemic therapies are emerging. To evaluate their usefulness and to make progress in the therapy of this disease, it is essential to enrol prostate cancer patients in clinical trials. Another important issue are bone metastases because they are a significant cause of pain and morbidity in prostate cancer patients. Palliation of pain can be achieved with different means like radiation therapy, radioisotopes, hormonal therapy, chemotherapy, and bisphosphonates. For the optimal treatment of patients with symptomatic advanced prostate cancer a multidisciplinary approach is mandatory.
前列腺癌是瑞士以及其他西方国家癌症相关死亡的第二大主要原因。对于晚期疾病患者，雄激素消融被视为最佳一线治疗方法。但这种治疗是姑息性的，中位缓解期约为18个月，激素难治性前列腺癌仍然是一个挑战。去年，两项大型随机试验首次证明基于多西他赛的疗法具有生存益处。此外，由于对激素难治性前列腺癌生物学的更好理解，一些新的全身治疗方法正在出现。为了评估它们的有效性并在这种疾病的治疗上取得进展，将前列腺癌患者纳入临床试验至关重要。另一个重要问题是骨转移，因为它们是前列腺癌患者疼痛和发病的重要原因。可以通过放疗、放射性同位素、激素治疗、化疗和双膦酸盐等不同方法实现疼痛缓解。对于有症状的晚期前列腺癌患者的最佳治疗，多学科方法是必不可少的。
