Sano Masayuki, Yamamoto Shinya, Uehara Sho, Yuasa Takeshi, Masuda Hitoshi, Fukui Iwao, Yonese Junji
Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
Mol Clin Oncol. 2016 Sep;5(3):208-210. doi: 10.3892/mco.2016.946. Epub 2016 Jul 1.
Antiandrogen withdrawal syndrome (AWS) is a well-established phenomenon in prostate cancer treated with combined androgen blockade (CAB). AWS is generally defined as subjective and/or objective improvement following discontinuation of an antiandrogen. However, the duration of the AWS response is usually limited. In addition, a complete response is quite rare. We herein present the case of a patient who achieved complete response from AWS, with the duration of this response lasting for >6 years. A 72-year-old man with metastatic prostate cancer received CAB with a luteinizing hormone-releasing hormone analog and bicalutamide. In addition, for local cancer control, external beam radiation therapy (70 Gy) to the prostate was performed. Subsequently, the serum prostate-specific antigen (PSA) level reached a nadir (undetectable level). Four years later, the patient's serum PSA level started to rise, and bicalutamide was discontinued to confirm AWS at a serum PSA level of 0.34 ng/ml. The PSA level immediately decreased again to an undetectable level (0.00 ng/ml), where it has been remained for 6 years. Bone scintigraphy and computed tomography scans have shown no evidence of bone or other metastases since the introduction of AWS. To the best of our knowledge, there have been no reports of such a long duration of complete response from AWS. Therefore, this phenomenon should always be considered, even in patients with advanced disease.
抗雄激素撤药综合征（AWS）是联合雄激素阻断（CAB）治疗前列腺癌时一种已被充分认识的现象。AWS通常定义为停用抗雄激素后出现的主观和/或客观改善。然而，AWS反应的持续时间通常有限。此外，完全缓解相当罕见。我们在此报告一例患者，其AWS获得完全缓解，且该反应持续时间超过6年。一名72岁的转移性前列腺癌男性患者接受了促性腺激素释放激素类似物和比卡鲁胺的CAB治疗。此外，为了进行局部癌症控制，对前列腺进行了体外放射治疗（70 Gy）。随后，血清前列腺特异性抗原（PSA）水平降至最低点（不可检测水平）。四年后，患者的血清PSA水平开始上升，停用比卡鲁胺以在血清PSA水平为0.34 ng/ml时确认AWS。PSA水平立即再次降至不可检测水平（0.00 ng/ml），并在此水平维持了6年。自出现AWS以来，骨闪烁显像和计算机断层扫描均未显示骨或其他转移的证据。据我们所知，尚无关于AWS如此长时间完全缓解的报道。因此，即使在晚期疾病患者中，也应始终考虑这种现象。
