Fowler J E, Pandey P, Seaver L E, Feliz T P
Division of Urology, University of Mississippi Medical Center, Jackson, USA.
J Urol. 1995 Aug;154(2 Pt 1):448-53. doi: 10.1097/00005392-199508000-00030.
We assess the impact of deferred flutamide treatment on the serum prostate specific antigen (PSA) level in patients with localized or metastatic cancer.
The study included 45 patients with localized cancer and 50 with metastatic cancer with an increasing (87) or stable (8) PSA level after gonadal androgen withdrawal.
Of 40 evaluable patients with localized cancer and 50 with metastatic cancer 32 (80%) and 27 (54%), respectively, had a PSA decrease of 50% or more of baseline during flutamide treatment (p = 0.014). Among patients with localized cancer actuarial analysis of freedom from PSA elevation during flutamide treatment favored those with a 50% or greater PSA decrease (p = 0.006) but in patients with metastatic cancer the analysis revealed no significant difference.
The relative density of tumor cells that are dependent on adrenal androgen after gonadal androgen withdrawal may be greater in patients with localized cancer and deferred flutamide treatment may enhance cancer control in those with localized disease.
我们评估延迟氟他胺治疗对局限性或转移性癌症患者血清前列腺特异性抗原（PSA）水平的影响。
该研究纳入了45例局限性癌症患者和50例转移性癌症患者，这些患者在性腺雄激素撤除后PSA水平呈上升（87例）或稳定（8例）。
在40例可评估的局限性癌症患者和50例转移性癌症患者中，分别有32例（80%）和27例（54%）在氟他胺治疗期间PSA下降至基线水平的50%或更多（p = 0.014）。在局限性癌症患者中，对氟他胺治疗期间无PSA升高的无事件生存率进行精算分析，结果显示PSA下降50%或更多的患者更具优势（p = 0.006），但在转移性癌症患者中，分析未显示出显著差异。
在性腺雄激素撤除后，依赖肾上腺雄激素的肿瘤细胞相对密度在局限性癌症患者中可能更高，延迟氟他胺治疗可能增强对局限性疾病患者的癌症控制。
