Ostri P, Bonnesen T, Nilsson T, Frimodt-Møller C
Department of Urology, Gentofte Hospital, University of Copenhagen, Denmark.
Urol Int. 1991;46(2):167-71. doi: 10.1159/000282125.
During a 2-year period, 37 patients with symptomatic metastatic prostatic cancer were included in a prospective randomized phase-III trial. Nineteen patients were randomized to subcapsular orchiectomy, and 18 to cyproterone acetate (CPA) treatment with a dose of 50 mg b.i.d. The median age of the patients was 74 years (range 48-88 years), with no differences between the treatment groups. At 3, 6, and 12 months after initiation of the therapy and then every 6 months, patients were clinically and biochemically examined, and isotope scans and X-rays were performed. All patients were followed until death. Relief from symptoms was found following 3 months of treatment in 70.6% (95% confidence limits = 44.0-89.7%) of the patients treated with CPA, and in 83.3% (95% confidence limits = 58.6-96.4%) of the orchiectomized patients. The median time to relapse was 9 months in the CPA group, and 11 months in the orchiectomy group (p greater than 0.05). The median survival time was 13 months, with no differences between the groups. The treatment of advanced prostatic cancer with CPA is found to be a valuable alternative to orchiectomy.
在2年期间，37例有症状的转移性前列腺癌患者被纳入一项前瞻性随机III期试验。19例患者被随机分配接受包膜下睾丸切除术，18例接受醋酸环丙孕酮（CPA）治疗，剂量为每日两次，每次50毫克。患者的中位年龄为74岁（范围48 - 88岁），治疗组之间无差异。在治疗开始后的3、6和12个月，然后每6个月，对患者进行临床和生化检查，并进行同位素扫描和X光检查。所有患者均随访至死亡。接受CPA治疗的患者中，70.6%（95%置信区间 = 44.0 - 89.7%）在治疗3个月后症状缓解，接受睾丸切除术的患者中这一比例为83.3%（95%置信区间 = 58.6 - 96.4%）。CPA组的中位复发时间为9个月，睾丸切除组为11个月（p大于0.05）。中位生存时间为13个月，组间无差异。发现用CPA治疗晚期前列腺癌是睾丸切除术的一种有价值的替代方法。
