D'Acremont B, Gattegno B, Cohen L, Fiatte P, Lucaks B, Thibault P
Clinique Urologique, Hôpital Tenon, Paris.
Ann Urol (Paris). 1990;24(2):87-95.
The most classical treatment of metastatic prostatic adenocarcinoma is hormone therapy. Most often, chemotherapy is proposed only when the tumor becomes hormonally unresponsive. But evaluation of its efficacy is impaired by the diversity of inclusion criteria used and by the different criteria of response assessment. Results of randomized, comparative studies show that all cytotoxic agents currently available have a similar response rate (about 30 to 40%). Use of combined chemotherapy does not seem to significantly improve these results. Several others ways have been proposed which attempt to improve the efficacy of chemotherapy (androgen stimulation, priming chemotherapy, adjuvant or neo-adjuvant chemotherapy...) but, most probably, progress will come from the discovery of more effective and selective cytotoxic agents, and not from the increase of clinical trials with the same agents.
转移性前列腺腺癌最经典的治疗方法是激素疗法。通常，仅在肿瘤对激素无反应时才会考虑化疗。但其疗效评估受到所用纳入标准的多样性以及不同反应评估标准的影响。随机对照研究结果表明，目前所有可用的细胞毒性药物的有效率相似（约30%至40%）。联合化疗似乎并未显著改善这些结果。人们还提出了其他几种方法来提高化疗疗效（雄激素刺激、诱导化疗、辅助或新辅助化疗等），但很可能，进展将来自于发现更有效、更具选择性的细胞毒性药物，而非增加对相同药物的临床试验。
