Smith D C
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, USA.
Semin Urol Oncol. 1997 Feb;15(1):3-12.
Almost all patients with metastatic prostate cancer will eventually develop hormone refractory disease. In general, these patients should be enrolled in a clinical trial designed to develop new therapies for the treatment of this disease. However, for a variety of reasons, some patients will not be candidates for these trials. In this setting, a secondary hormonal therapy is a viable option. Secondary hormonal therapy continues and extends the two basic approaches used in primary hormonal therapy: reduction in circulating androgens and competitive inhibition of androgen receptor binding. This article reviews the basic concepts of secondary hormonal therapy, including maintenance of testicular androgen suppression, the anti-androgen withdrawal syndrome, and the available agents. In addition, it reviews hormonal agents currently in development that act by other mechanisms to inhibit prostate cancer growth.
几乎所有转移性前列腺癌患者最终都会发展为激素难治性疾病。一般来说，这些患者应参加旨在开发治疗该疾病新疗法的临床试验。然而，由于各种原因，一些患者不适合参加这些试验。在这种情况下，二线激素治疗是一种可行的选择。二线激素治疗延续并扩展了一线激素治疗中使用的两种基本方法：降低循环雄激素水平以及竞争性抑制雄激素受体结合。本文回顾了二线激素治疗的基本概念，包括维持睾丸雄激素抑制、抗雄激素撤药综合征以及可用药物。此外，还回顾了目前正在研发的通过其他机制抑制前列腺癌生长的激素药物。
