Sekido N, Kawai K, Akaza H, Koiso K
Department of Urology, Tsukuba Gakuen Hospital, Ibaraki.
Jpn J Clin Oncol. 1995 Aug;25(4):164-7.
Between July 1991 and December 1994 at Tsukuba Gakuen Hospital, we treated 19 consecutive men with advanced adenocarcinoma of the prostate (five at stage C, four at stage D1 and 10 at stage D2). Of these, 14 patients underwent castration (two patients) or received LH-RH analogue (12 patients) plus chlormadinone acetate for combined androgen blockade. We report three representative cases of sequential prostate specific antigen (PSA) elevation following initial response to this combined androgen blockade. Discontinuation of chlormadinone acetate resulted in decline of the serum PSA level. This suggests that trial chlormadinone acetate withdrawal in patients showing increasing levels of PSA during combined androgen blockade should be considered before initiation of alternative treatment.
1991年7月至1994年12月期间，我们在筑波学园医院连续治疗了19例晚期前列腺腺癌男性患者（C期5例，D1期4例，D2期10例）。其中，14例患者接受了去势治疗（2例）或接受促性腺激素释放激素（LH-RH）类似物（12例）加醋酸氯地孕酮进行联合雄激素阻断治疗。我们报告了3例具有代表性的病例，这些患者在对这种联合雄激素阻断治疗产生初始反应后出现前列腺特异性抗原（PSA）水平相继升高的情况。停用醋酸氯地孕酮后血清PSA水平下降。这表明，在开始替代治疗之前，应考虑对在联合雄激素阻断治疗期间PSA水平升高的患者试用停用醋酸氯地孕酮的方法。
