de Voogt H J, Studer U, Schröder F H, Klijn J G, de Pauw M, Sylvester R
Free University Hospital, Amsterdam, The Netherlands.
Eur Urol. 1998;33(2):152-8. doi: 10.1159/000019547.
This is the final analysis of EORTC GU Group Trial 30843 in which the treatment of advanced, metastatic prostate cancer with a combination of the LHRH agonist buserelin (nasal spray) and cyproterone acetate (Androcur), either continuously of only during the first 2 weeks, was compared with orchidectomy. There was no significant difference between the three arms as far as response rate, time to progression (subjective and objective) and duration of survival are concerned. Retrospective stratification according to the most important prognostic factors did not change the conclusions. Possible reasons for the difference with trial 30853, which used the same entry criteria but compared goserelin and flutamide with orchidectomy, are discussed. Reasons for using cyproterone acetate in combination treatment are the prevention of flare of the disease after LHRH agonists only and the prevention/reduction of toxicity in the form of hot flushes.
这是欧洲癌症研究与治疗组织泌尿生殖系统肿瘤协作组30843试验的最终分析，该试验比较了促黄体生成素释放激素（LHRH）激动剂布舍瑞林（鼻喷雾剂）和醋酸环丙孕酮（安宫黄体酮）联合使用（持续用药或仅在前2周用药）与睾丸切除术治疗晚期转移性前列腺癌的效果。就缓解率、疾病进展时间（主观和客观）及生存期而言，三组之间无显著差异。根据最重要的预后因素进行回顾性分层并未改变结论。文中讨论了与30853试验结果不同的可能原因，30853试验采用相同的入选标准，但比较了戈舍瑞林和氟他胺与睾丸切除术的效果。联合治疗中使用醋酸环丙孕酮的原因是仅使用LHRH激动剂时预防疾病发作，以及预防/减少潮热形式的毒性。
