Robinson M R, Thomas B S
Br Med J. 1971 Nov 13;4(5784):391-4. doi: 10.1136/bmj.4.5784.391.
Plasma concentrations of testosterone were estimated in normal men, in patients before treatment for prostatic cancer, and in patients who had had various forms of endocrine treatment for prostatic carcinoma. There was no decline in plasma testosterone levels with age. Patients with non-metastatic disease had levels similar to those of normal controls, but in advanced metastatic disease the levels were low. After orchidectomy the plasma testosterone level fell to that found in normal women. In every patient stilboestrol in doses as small as 1 mg three times a day suppressed plasma testosterone at first to negligible amounts, irrespective of the clinical response. Subsequently a small but significant rise in the concentration was always observed over a period of six months' oestrogen therapy. Pituitary ablation with yttrium-90 lowered the plasma testosterone concentration again to negligible amounts in patients who had been on stilboestrol. In advanced metastatic disease this was often associated with relief of pain. Preliminary studies with aminoglutethimide indicate that it can produce biochemical and clinical effects similar to those of pituitary ablation.
对正常男性、前列腺癌治疗前的患者以及接受过各种形式前列腺癌内分泌治疗的患者的血浆睾酮浓度进行了评估。血浆睾酮水平不会随年龄下降。非转移性疾病患者的睾酮水平与正常对照组相似，但在晚期转移性疾病中，睾酮水平较低。睾丸切除术后，血浆睾酮水平降至正常女性的水平。在每位患者中，无论临床反应如何，每天三次服用低至1毫克的己烯雌酚起初都会将血浆睾酮抑制到可忽略不计的水平。随后，在为期六个月的雌激素治疗期间，总是观察到睾酮浓度有小幅但显著的升高。对于接受过己烯雌酚治疗的患者，用钇-90进行垂体消融可再次将血浆睾酮浓度降至可忽略不计的水平。在晚期转移性疾病中，这通常与疼痛缓解相关。氨鲁米特的初步研究表明，它能产生与垂体消融类似的生化和临床效果。
