Robustelli della Cuna G, Zanon P, Pavesi L, Preti P, Prada G A, Decensi A
Chemioterapia. 1986 Jun;5(3):164-72.
High-dose medroxyprogesterone acetate (HD-MPA) has been successfully employed in the treatment of hormone-related tumors, especially advanced breast cancer. However, progestins in general and MPA in particular are considered a useful treatment also in other types of tumors such as endometrial, prostatic and renal cancer. Furthermore, MPA has been evaluated in tumors which are not classically considered hormone-related, such as ovarian cancer. Therapy with one of a number of progestational agents has been the conventional approach to the management of endometrial carcinoma not amenable to surgery or radiation therapy. Among the various synthetic progestins, MPA has been the most widely employed both by i.m. and oral routes, according to a variety of doses and schedules. Objective responses have been obtained in a percentage of women varying between 30 and 50% in the different series. While the role of MPA in the palliative treatment of advanced disease is well accepted, opinion is divided on the role of progestins in the adjuvant setting. On the basis of available data, it should be concluded that the usefulness of adjuvant therapy with progestins in high risk, early-stage endometrial cancer has not yet been clearly demonstrated. As far as prostatic cancer is concerned, data coming from comparative trials show that MPA is less effective than diethylstilbestrol (DES), and therefore should not be considered the first choice for previously untreated patients. However, it can achieve responses in patients who no longer respond or who are refractory to DES, and represents the treatment of choice for those patients who, due to their cardiovascular conditions, cannot be given estrogens.(ABSTRACT TRUNCATED AT 250 WORDS)
大剂量醋酸甲羟孕酮（HD-MPA）已成功用于治疗激素相关肿瘤，尤其是晚期乳腺癌。然而，一般的孕激素，特别是甲羟孕酮，在其他类型的肿瘤如子宫内膜癌、前列腺癌和肾癌中也被认为是一种有效的治疗方法。此外，甲羟孕酮已在一些通常不被认为与激素相关的肿瘤如卵巢癌中进行了评估。使用多种孕激素制剂之一进行治疗一直是无法进行手术或放射治疗的子宫内膜癌的传统管理方法。在各种合成孕激素中，甲羟孕酮通过肌肉注射和口服途径，根据不同的剂量和给药方案，应用最为广泛。在不同系列中，一定比例的女性获得了客观缓解，缓解率在30%至50%之间。虽然甲羟孕酮在晚期疾病姑息治疗中的作用已得到广泛认可，但对于孕激素在辅助治疗中的作用存在分歧。根据现有数据，应该得出结论，孕激素在高危早期子宫内膜癌辅助治疗中的有效性尚未得到明确证实。就前列腺癌而言，来自比较试验的数据表明，甲羟孕酮的疗效低于己烯雌酚（DES），因此不应被视为初治患者的首选。然而，它可以使不再对DES有反应或对DES难治的患者产生反应，并且是那些因心血管疾病不能使用雌激素的患者的首选治疗方法。（摘要截取自250字）
