Matsumoto K, Noguchi S
Dept. of Pathology, Osaka University Medical School.
Gan To Kagaku Ryoho. 1987 Oct;14(10):2816-23.
Inhibitory effects of hormone therapy on the growth of cancer can be found only in cancers whose growth is stimulated by hormones. Among the various kinds of steroid-or peptide-dependent (or responsive) tumors, estrogen-dependent breast and endometrial cancers and androgen-dependent prostate cancer have been shown to have high incidences. Therefore, the suppression or disappearance of the production or action of estrogens or androgens has been used as a common form of hormone therapy. Although surgical therapies such as removal of the ovaries, adrenals, hypophysis or testes have been used as the major hormone therapies, medicinal therapies such as the administration of antiestrogen, aminoglutethimide, medroxyprogesterone acetate, antiandrogen and/or high doses of LHRH have recently become the major types of hormone therapy. Fortunately, hormone therapy produces very few side effects compared with various other therapies for cancer. However, hormone therapy has been shown to be effective only in 30% of breast cancers or endometrial cancers, and 70% of prostate cancers. Furthermore, loss of hormone dependency generally occurs during hormone therapy. Therefore, useful methods for the growth inhibition of hormone-independent recurrent tumors should be developed. Various kinds of chemotherapies combined with hormone therapies have recently been used. Although these chemoendocrine therapies have resulted in an increase in response rate, overall survival has not been significantly improved in comparison with endocrine therapy alone. Since recent findings have shown that the growth of sex steroid-dependent cancer is mediated by sex steroid-induced growth factor (s) secreted by the cancer cells(autocrine control), suppression of the production or action of such growth factor (s) should be investigated as a future form of endocrine therapy; a loss of hormone dependency might occur through the production of such growth factor (s) without hormone stimulation.
激素疗法对癌症生长的抑制作用仅见于那些生长受激素刺激的癌症。在各类依赖类固醇或肽(或对其有反应)的肿瘤中,雌激素依赖的乳腺癌和子宫内膜癌以及雄激素依赖的前列腺癌发病率较高。因此,抑制或消除雌激素或雄激素的产生或作用已成为激素疗法的常见形式。尽管诸如切除卵巢、肾上腺、垂体或睾丸等手术疗法曾被用作主要的激素疗法,但近年来,诸如给予抗雌激素、氨鲁米特、醋酸甲羟孕酮、抗雄激素和/或高剂量促性腺激素释放激素等药物疗法已成为主要的激素治疗类型。幸运的是,与其他各种癌症治疗方法相比,激素疗法产生的副作用很少。然而,激素疗法仅对30%的乳腺癌或子宫内膜癌以及70%的前列腺癌有效。此外,激素依赖性丧失通常发生在激素治疗期间。因此,应开发抑制激素非依赖性复发性肿瘤生长的有效方法。最近已使用了各种与激素疗法联合的化疗方法。尽管这些化学内分泌疗法使缓解率有所提高,但与单纯内分泌疗法相比,总体生存率并未得到显著改善。由于最近的研究结果表明,性类固醇依赖性癌症的生长是由癌细胞分泌的性类固醇诱导生长因子介导的(自分泌控制),因此应研究抑制此类生长因子的产生或作用,作为未来内分泌治疗的一种形式;在没有激素刺激的情况下,此类生长因子的产生可能导致激素依赖性丧失。