Urology Academic Department of la Pitié-Salpêtrière Hospital, Assistance Publique- Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France.
BJU Int. 2012 Dec;110(11 Pt C):E826-9. doi: 10.1111/j.1464-410X.2012.11206.x. Epub 2012 May 11.
What's known on the subject? and What does the study add? Diethylstilbestrol (DES) has been found to have anti-tumour properties and clinical effectiveness in prostate cancer that is resistant to the first-line hormonal therapy. This review found that low-dose DES has anti-tumour efficacy with limited cardiovascular side effects and should be considered for secondary hormone manoeuvres. The aim of this review was to describe the most recent data from contemporary clinical trials of diethylstilbestrol (DES) to better determine its current role in advanced prostate cancer treatment as new hormonal therapies emerge. Relevant clinical studies using 1 mg of DES in castrate-resistant prostate cancer (CRPC) were identified from the literature, clinical trial databases, websites and conference abstracts. The efficacy and safety outcomes were summarized. DES in CRPC produced a biological response (change in PSA level) and improved the median survival of patients when used as a second-line hormone therapy after standard androgen deprivation with bicalutamide and LHRH analogues. These findings were for low doses of DES. The 1-mg dose is associated with a reduced toxicity, including fewer thromboembolic and cardiovascular events. Low-dose DES appears to be safe and effective for CRPC before initiating chemotherapy. The cost/efficiency ratio may encourage physicians to consider DES as a therapy option before chemotherapy in non-symptomatic CRPC.
DES 已被发现具有抗肿瘤特性和临床疗效，可用于治疗对一线激素治疗耐药的前列腺癌。
本综述发现，低剂量 DES 具有抗肿瘤疗效，且心血管副作用有限，应考虑作为二线激素治疗。本综述旨在描述最近关于 DES 的临床研究数据，以便更好地确定其在新兴激素治疗出现时在晚期前列腺癌治疗中的作用。
从文献、临床试验数据库、网站和会议摘要中确定了使用 1 毫克 DES 治疗去势抵抗性前列腺癌（CRPC）的相关临床研究。总结了疗效和安全性结果。当作为标准雄激素剥夺治疗（比卡鲁胺和 LHRH 类似物）后二线激素治疗时，DES 在 CRPC 中产生了生物学反应（PSA 水平变化）并改善了患者的中位生存。这些发现是针对低剂量 DES 的。1 毫克剂量与降低毒性相关，包括血栓栓塞和心血管事件减少。低剂量 DES 在开始化疗前似乎对 CRPC 安全有效。成本/效率比可能会促使医生在非症状性 CRPC 中考虑将 DES 作为化疗前的一种治疗选择。
