Wolff J M
Urologische Klinik am St.-Cornelius-Hospital, Allgemeines Krankenhaus, Viersen GmbH, Heesstrasse 10, Viersen.
Aktuelle Urol. 2009 May;40(3):159-63. doi: 10.1055/s-0028-1098882. Epub 2009 Apr 27.
At present medical castration employing luteinising hormone releasing hormone (LHRH) agonists is the standard of care for patients with advanced prostate cancer. LHRH agonists suppress the synthesis of testosterone to a castration level. In contrast to surgical castration, medical castration is reversible. However LHRH agonists induce an initial increase of the testosterone level. This so-called testosterone surge leads to tumour growth and increases the disease-specific complaints, known as flare phenomena. It may be possible that the overall survival of these patients is deteriorated. In contrast, gonadotrophin releasing hormone (GnRH) antagonists do not induce a testosterone surge and the level of testosterone decreases as rapidly as that known from a surgical castration.
目前，使用促黄体生成素释放激素（LHRH）激动剂进行药物去势是晚期前列腺癌患者的标准治疗方法。LHRH激动剂可将睾酮合成抑制到去势水平。与手术去势不同，药物去势是可逆的。然而，LHRH激动剂会使睾酮水平最初升高。这种所谓的睾酮激增会导致肿瘤生长并增加疾病特异性症状，即“flare现象”。这些患者的总生存期可能会恶化。相比之下，促性腺激素释放激素（GnRH）拮抗剂不会引起睾酮激增，睾酮水平下降的速度与手术去势时一样快。
