Fowler J E, Bigler S A, Kolski J M, Yee D T
Division of Urology, University of Mississippi School of Medicine, Jackson 39216, USA.
Cancer. 1998 Mar 15;82(6):1112-7.
Locally advanced prostate carcinoma is usually not curable with surgery or radiation therapy. Primary hormone therapy is an alternative therapeutic option, but contemporary prospective studies of the outcomes of such therapy are not available.
The authors conducted a prospective, hospital-based study of gonadal androgen ablation with deferred antiandrogen therapy in 103 men with prostate carcinoma clinically classified as T3-4NXM0. The median potential follow-up was 51 months (range, 36-74 months), and the median period of observation was 43 months (range, 6-74 months).
Each patient experienced regression of the primary tumor, and none experienced significant morbidity from the primary tumor during the study period. The projected 5-year cause specific, metastasis free, PSA disease free (no PSA elevation > 1.0 ng/mL after the beginning of antiandrogen therapy), and all-cause survival rates were 84%, 84%, 68%, and 58%, respectively.
Primary hormone therapy is a reasonable treatment option for locally advanced prostate carcinoma in elderly men or in men with significant comorbid disease who request therapeutic intervention.
局部晚期前列腺癌通常无法通过手术或放射治疗治愈。原发性激素治疗是一种替代治疗选择，但目前尚无关于此类治疗结果的当代前瞻性研究。
作者对103例临床分类为T3 - 4NXM0的前列腺癌男性患者进行了一项基于医院的前瞻性研究，采用延迟抗雄激素治疗的性腺雄激素消融术。中位潜在随访时间为51个月（范围36 - 74个月），中位观察期为43个月（范围6 - 74个月）。
每位患者的原发肿瘤均出现消退，且在研究期间无患者因原发肿瘤出现严重并发症。预计5年的病因特异性、无转移、无PSA疾病（抗雄激素治疗开始后PSA升高不超过1.0 ng/mL）和全因生存率分别为84%、84%、68%和58%。
对于老年男性或有严重合并症且要求进行治疗干预的局部晚期前列腺癌患者，原发性激素治疗是一种合理的治疗选择。
