Urology Department, North Hospital, St Etienne cedex, France.
Oncol Res Treat. 2015;38(12):646-52. doi: 10.1159/000441734. Epub 2015 Nov 16.
Androgen deprivation therapy is the cornerstone treatment for metastatic prostate cancer. It can be done either surgically or medically. Luteinizing hormone-releasing hormone agonists and antagonist are the most effective drugs, with different side effects and modes of action, but no clear efficacy differences. Adding a non-steroidal antiandrogen adds a marginal benefit but also significant side effects and costs. Non-steroidal antiandrogens should not be used as monotherapy. In most patients with metastases, immediate castration is the standard of care. The intermittent modality is apparently non-inferior to the continuous one, with some other benefits. Upfront chemotherapy added to castration should be considered as the new standard of care in many metastatic patients. Castration leads to many adverse effects, some potentially life-threatening such as cardiovascular side effects.
雄激素剥夺疗法是转移性前列腺癌的基础治疗方法。它可以通过手术或药物治疗来完成。黄体生成素释放激素激动剂和拮抗剂是最有效的药物，具有不同的副作用和作用模式，但没有明显的疗效差异。添加非甾体类抗雄激素可带来微小的益处，但也会产生显著的副作用和费用。非甾体类抗雄激素不应作为单一药物治疗。对于大多数转移性患者，立即去势是标准的治疗方法。间歇性方法显然不比连续方法差，还有一些其他好处。在许多转移性患者中，将化疗药物与去势联合使用应被视为新的标准治疗方法。去势会导致许多不良反应，有些可能危及生命，如心血管副作用。
