Abrahamsson Per-Anders
Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden.
Asian J Urol. 2017 Oct;4(4):208-222. doi: 10.1016/j.ajur.2017.04.001. Epub 2017 Apr 22.
Intermittent androgen deprivation therapy (IADT) is now being increasingly opted by the treating physicians and patients with prostate cancer. The most common reason driving this is the availability of an off-treatment period to the patients that provides some relief from treatment-related side-effects, and reduced treatment costs. IADT may also delay the progression to castration-resistant prostate cancer. However, the use of IADT in the setting of prostate cancer has not been strongly substantiated by data from clinical trials. Multiple factors seem to contribute towards this inadequacy of supportive data for the use of IADT in patients with prostate cancer, e.g., population characteristics (both demographic and clinical), study design, treatment regimen, on- and off-treatment criteria, duration of active treatment, endpoints, and analysis. The present review article focuses on seven clinical trials that evaluated the efficacy of IADT . continuous androgen deprivation therapy for the treatment of prostate cancer. The results from these clinical trials have been discussed in light of the factors that may impact the treatment outcomes, especially the disease (tumor) burden. Based on evidence, potential candidate population for IADT has been suggested along with recommendations for the use of IADT in patients with prostate cancer.
目前，治疗前列腺癌的医生和患者越来越多地选择间歇性雄激素剥夺疗法（IADT）。促使这种情况出现的最常见原因是患者有一段停止治疗的时期，这能在一定程度上缓解治疗相关的副作用，并降低治疗成本。IADT还可能延缓前列腺癌向去势抵抗性前列腺癌的进展。然而，在前列腺癌治疗中使用IADT尚未得到临床试验数据的有力证实。多种因素似乎导致了在前列腺癌患者中使用IADT缺乏支持性数据，例如人群特征（包括人口统计学和临床特征）、研究设计、治疗方案、治疗期和非治疗期标准、积极治疗的持续时间、终点指标以及分析方法。本综述文章聚焦于七项评估IADT（连续雄激素剥夺疗法）治疗前列腺癌疗效的临床试验。已根据可能影响治疗结果，尤其是疾病（肿瘤）负担的因素，对这些临床试验的结果进行了讨论。基于证据，提出了IADT的潜在候选人群以及在前列腺癌患者中使用IADT的建议。
