Linares Espinos Estefania, Carballido Rodriguez Joaquin
Servicio y Cátedra de Urología. Hospital Universitario Puerta de Hierro-Majadahonda. Universidad Autónoma de Madrid. España.
Arch Esp Urol. 2014 Jun;67(5):457-61.
Active surveillance (AS) as a therapeutic option is already integrated as a primary treatment strategy in low risk localized prostate cancer (PCa). There is a recent interest for the search of therapeutic interventions that result in a delay in the progression of such indolent cancers. The evaluation of the possible implication of 5 ARI drugs in the reduction of the risk of progression of PCa was enacted by the results of the clinical trials PCPT (Prostate Cancer Prevention Trial) and REDUCE (Reduction by Dutasteride of Prostate Cancer Events study). The results of the REDEEM clinical trial (Reduction by Dutasteride of clinical progression events in expectant management trial) revealed a delay in PCa progression favoring Dutasteride in comparison with placebo, being advanced age and PSA Density independent predictive factors for pathologic progression. Evidences regarding the influence of 5 ARIs in the evolution of AS patients come from few studies with limited follow up. Thus, the conclusions probably are far from being consiidered as definitive.
主动监测（AS）作为一种治疗选择，已被纳入低风险局限性前列腺癌（PCa）的主要治疗策略。最近人们对寻找能够延缓此类惰性癌症进展的治疗干预措施产生了兴趣。5α还原酶抑制剂（5 ARI）药物在降低PCa进展风险方面可能的作用，是根据PCPT（前列腺癌预防试验）和REDUCE（度他雄胺降低前列腺癌事件研究）临床试验的结果进行评估的。REDEEM临床试验（度他雄胺降低期待治疗试验中临床进展事件）的结果显示，与安慰剂相比，度他雄胺可延缓PCa进展，高龄和PSA密度是病理进展的独立预测因素。关于5 ARI对AS患者病情发展影响的证据来自少数随访有限的研究。因此，这些结论可能远未被视为定论。
