Schulze H, Isaacs J T
Cancer Surv. 1986;5(3):487-503.
There is no effective therapy for increasing the survival of metastatic prostatic cancer. New approaches to this major disease are urgently needed. One approach is to study the biology of prostatic carcinogenesis in order to develop a treatment that prevents the initial development of clinically manifest prostatic cancer. International epidemiological data on the incidence of prostatic cancer and the data on migrant populations make this both possible and practical. For example, it should be possible to lower the incidence of clinical prostatic cancer by more than ten-fold among men in the United States. An alternative approach is to study the tumour biology of prostatic cancer to identify better methods for treating established clinical prostatic cancer. Such studies have already demonstrated that individual prostatic cancers are composed of clones of cancer cells that are phenotypically heterogeneous even before therapy is initiated. Because of this tumour cell heterogeneity, future studies should be directed towards combining androgen ablation plus chemotherapy and/or radiation early in the disease in order to affect both the androgen-dependent and the androgen-independent cancer cells present in individual prostatic cancers.
目前尚无有效的疗法可提高转移性前列腺癌患者的生存率。对于这种重大疾病，迫切需要新的治疗方法。一种方法是研究前列腺癌发生的生物学机制，以便开发出一种能够预防临床明显前列腺癌初始发展的治疗方法。关于前列腺癌发病率的国际流行病学数据以及移民人群的数据使得这一方法既可行又实际。例如，在美国男性中，应该有可能将临床前列腺癌的发病率降低十倍以上。另一种方法是研究前列腺癌的肿瘤生物学，以确定更好的治疗已确诊临床前列腺癌的方法。此类研究已经表明，即使在开始治疗之前，单个前列腺癌也是由表型异质的癌细胞克隆组成。由于这种肿瘤细胞异质性，未来的研究应致力于在疾病早期将雄激素剥夺与化疗和/或放疗相结合，以影响单个前列腺癌中存在的雄激素依赖性和雄激素非依赖性癌细胞。
