Knönagel H, Hauri D
Helv Chir Acta. 1989 Aug;56(3):347-50.
Following the hypothesis of depressing adrenal androgens in patients with relapsed prostatic carcinoma using Aminoglutethimide (AG), we performed a prospective study during three years, beginning in 1983. Twenty orchiectomized men aged 61-83 (mean 77) with progressive prostate carcinoma stage D2 (T0-4 Nx M1) were included. They received 4 x 250 mg AG and 50 mg cortisone daily. Overall response, according to NPCP-criteria, was 30% after 3 months (1 patient with partial remission and 5 patients stable), and at the end of trial 1 patient (5%) remained stable and 7 (65%) had progression. Laboratory controls of adrenal androgens did not show any significant change of androstenedione and DHEA-S within 3 months, and there was even an average rise of testosterone from 1 to 2 nmol/l. AG seems to be only of small advantage in secondary treatment of advanced prostatic carcinoma. But it is possible that aromatase inhibitors could be useful in treating BPH because of their influence on peripheral oestrogens.
基于使用氨鲁米特(AG)降低复发性前列腺癌患者肾上腺雄激素的假说,我们于1983年开始进行了一项为期三年的前瞻性研究。纳入了20名年龄在61 - 83岁(平均77岁)的睾丸切除术后患有进展期前列腺癌D2期(T0 - 4 Nx M1)的男性。他们每天接受4×250毫克AG和50毫克可的松治疗。根据NPCP标准,3个月后的总体缓解率为30%(1例部分缓解,5例病情稳定),在试验结束时,1例(5%)病情保持稳定,7例(65%)病情进展。肾上腺雄激素的实验室检查显示,3个月内雄烯二酮和硫酸脱氢表雄酮没有任何显著变化,睾酮甚至平均从1纳摩尔/升升至2纳摩尔/升。AG在晚期前列腺癌的二线治疗中似乎只有很小的优势。但由于芳香化酶抑制剂对外周雌激素的影响,它们可能对治疗良性前列腺增生有用。