Akakura K, Akimoto S, Ohki T, Shimazaki J
Department of Urology, School of Medicine, Chiba University, Japan.
Urology. 1995 Apr;45(4):700-4; discussion 704-5. doi: 10.1016/S0090-4295(99)80070-3.
A case report is presented of 2 patients whose levels of serum prostate-specific antigen (PSA) improved after the withdrawal of a steroidal antiandrogen.
Two cases with prostate cancer had been treated with surgical castration and the steroidal antiandrogen chlormadinone acetate (CMA), and, on disease progression, the administration of CMA was terminated.
Following withdrawal of CMA, a fall in PSA levels and remarkable clinical improvement were observed in both cases. One patient revealed a decrease and the other an increase in serum prostate acid phosphatase after the discontinuation of CMA. Serum levels of testosterone, prolactin, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and androstenedione were not significantly elevated after CMA withdrawal.
Withdrawal of the steroidal antiandrogen CMA resulted in a decline in PSA levels and clinical improvement in prostate cancer patients with disease progression. Changes in testosterone, prolactin, or adrenal androgens were not a cause of the antiandrogen withdrawal syndrome.
报告2例患者在停用甾体类抗雄激素药物后血清前列腺特异性抗原（PSA）水平有所改善的病例。
2例前列腺癌患者接受了手术去势及甾体类抗雄激素醋酸氯地孕酮（CMA）治疗，疾病进展后终止了CMA给药。
停用CMA后，2例患者的PSA水平均下降，临床症状显著改善。停用CMA后，1例患者血清前列腺酸性磷酸酶下降，另1例升高。停用CMA后，睾酮、催乳素、脱氢表雄酮、硫酸脱氢表雄酮和雄烯二酮的血清水平未显著升高。
停用甾体类抗雄激素CMA可使疾病进展的前列腺癌患者的PSA水平下降并临床症状改善。睾酮、催乳素或肾上腺雄激素的变化并非抗雄激素撤药综合征的病因。
