Akaza Hideyuki
Urology and Andrology, Functional and Regulatory Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
Cancer Sci. 2006 Apr;97(4):243-7. doi: 10.1111/j.1349-7006.2006.00180.x.
It has been conventionally accepted that primary androgen depletion therapy (PADT) is effective only as a palliative treatment against localized prostate cancer (LPC) and locally advanced prostate cancer (LAPC), like its effect against advanced (metastatic) prostate cancer. In Japan, however, PADT has long been the treatment of choice for LPC and LAPC. The frequency of PADT being chosen to treat LPC and LAPC is also on the rise in clinical practice in the USA. Very little evidence to support this trend has so far been available. A study on the outcomes of endocrine therapy is currently being conducted in Japan by the Japanese Prostate Cancer Surveillance Group. Results of several domestic and overseas randomized trials have recently been published, and evidence for the efficacy of PADT in LPC and LAPC has been accumulating. The effectiveness of PADT in LAPC, in particular, is worthy of attention. There is a possibility that therapeutic strategies for LPC and LAPC may change dramatically in the near future.
传统观点认为,原发性雄激素剥夺疗法(PADT)仅作为一种姑息性治疗手段,用于治疗局限性前列腺癌(LPC)和局部晚期前列腺癌(LAPC),就如同其对晚期(转移性)前列腺癌的治疗效果一样。然而,在日本,PADT长期以来一直是LPC和LAPC的首选治疗方法。在美国的临床实践中,选择PADT治疗LPC和LAPC的频率也在上升。迄今为止,几乎没有证据支持这一趋势。日本前列腺癌监测小组目前正在日本开展一项关于内分泌治疗结果的研究。最近,国内外几项随机试验的结果已经发表,支持PADT治疗LPC和LAPC有效性的证据也在不断积累。特别是,PADT在LAPC中的有效性值得关注。在不久的将来,LPC和LAPC的治疗策略有可能发生巨大变化。