Schulze H, Isaacs J, Senge T
J Urol. 1987 May;137(5):909-11. doi: 10.1016/s0022-5347(17)44292-3.
It has been proposed that early treatment of patients with advanced prostatic cancer by surgical or medical orchiectomy when combined with a direct acting antiandrogen will result in a more complete form of androgen blockade, thereby increasing response and survival rates compared to orchiectomy alone. We treated 55 patients with previously untreated advanced prostatic cancer by bilateral orchiectomy and additional administration of 50 mg. of the direct acting antiandrogen cyproterone acetate orally per day. Therefore, these patients have undergone a combination therapy that meets the requirements of the proposed complete androgen blockade. All 22 patients with metastases at hospitalization died during the first 4 years of treatment. Among the 33 patients without clinical evidence of metastases at hospitalization 18 were alive after 5 years. Retrospectively, the direct observed 5-year survival rate for the patients treated with a complete androgen blockade did not show any advantage compared to reported data with orchiectomy alone.
有人提出，对晚期前列腺癌患者早期采用手术或药物去势治疗，并结合直接作用的抗雄激素药物，将导致更完全形式的雄激素阻断，从而与单独去势相比提高缓解率和生存率。我们对55例先前未经治疗的晚期前列腺癌患者进行了双侧去势，并每天额外口服50毫克直接作用的抗雄激素药物醋酸环丙孕酮。因此，这些患者接受了符合所提议的完全雄激素阻断要求的联合治疗。所有22例住院时有转移的患者在治疗的前4年内死亡。在33例住院时无转移临床证据的患者中，18例在5年后仍存活。回顾性分析，接受完全雄激素阻断治疗的患者直接观察到的5年生存率与单独去势的报告数据相比没有显示出任何优势。
