Silver R I, Straus F H, Vogelzang N J, Kellman H, Chodak G W
Department of Surgery, Pritzker School of Medicine, University of Chicago, Illinois.
Urology. 1991 Jan;37(1):17-21. doi: 10.1016/0090-4295(91)80070-n.
Serum testosterone and prostate-specific antigen (PSA) levels were measured in 3 patients with Stage D2 prostate cancer before and after discontinuation of the long-acting LHRH agonist, goserelin acetate (Zoladex). The patients had received goserelin acetate for ten, sixteen, and thirty months prior to discontinuing the drug because of progressive metastatic disease. In all 3 patients, PSA and testosterone levels increased after goserelin acetate was discontinued. In 2 patients the testosterone level reached normal levels. A bilateral orchiectomy was performed one hundred sixty, one hundred, and seven days, respectively, after the drug was discontinued. In all 3 cases PSA and testosterone levels were reduced following castration, although PSA levels again began to increase within two weeks of orchiectomy in 2 of the 3 patients. These findings suggest that suppression of testosterone by LHRH agonists is not permanent and if tumor progression occurs, maintaining hormone suppression may still be beneficial.
在3例D2期前列腺癌患者停用长效促性腺激素释放激素（LHRH）激动剂醋酸戈舍瑞林（Zoladex）前后，测定了他们的血清睾酮和前列腺特异性抗原（PSA）水平。由于疾病进展出现转移，这3例患者在停药前分别接受了10个月、16个月和30个月的醋酸戈舍瑞林治疗。在所有3例患者中，停用醋酸戈舍瑞林后PSA和睾酮水平均升高。2例患者的睾酮水平恢复到正常水平。在停药后分别于第160天、100天和7天进行了双侧睾丸切除术。在所有3例病例中，去势后PSA和睾酮水平均降低，尽管3例患者中有2例在睾丸切除术后两周内PSA水平再次开始升高。这些发现表明，LHRH激动剂对睾酮的抑制作用并非永久性的，如果发生肿瘤进展，维持激素抑制可能仍然有益。
