Spahn M, Krebs M
Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinik Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Deutschland.
Urologe A. 2012 Jan;51(1):15-9. doi: 10.1007/s00120-011-2738-9.
After an average of 18-36 months under androgen suppression therapy by surgical castration, LHRH, and steroidal or non-steroidal antiandrogens, almost all patients with metastatic prostate cancer show PSA progression as a sign of androgen-independent but still androgen-sensitive tumor growth. Our understanding and the treatment of such castration-resistant prostate cancer has changed markedly. The introduction of new drugs like abiraterone and MDV3100 has shown that prostate cancer progression even in the"hormone-refractory" stage is driven by androgen receptor signaling. Based on this information the question of whether androgen deprivation therapy in castration-resistant prostate cancer should be continued or not is still of relevance. This review gives a critical overview of the literature and current guideline recommendations.
在通过手术去势、促性腺激素释放激素（LHRH）以及甾体或非甾体抗雄激素药物进行平均18至36个月的雄激素抑制治疗后，几乎所有转移性前列腺癌患者都会出现前列腺特异性抗原（PSA）进展，这是雄激素非依赖性但仍对雄激素敏感的肿瘤生长的标志。我们对这种去势抵抗性前列腺癌的认识和治疗方法已经发生了显著变化。阿比特龙和MDV3100等新药的推出表明，即使在“激素难治性”阶段，前列腺癌的进展也是由雄激素受体信号传导驱动的。基于这一信息，去势抵抗性前列腺癌中雄激素剥夺治疗是否应继续的问题仍然具有相关性。本综述对相关文献和当前指南建议进行了批判性概述。
