Breul J, Paul R
Urologische Klinik und Poliklinik, Technischen Universität München, Klinikum rechts der Isar.
Urologe A. 1998 Mar;37(2):156-8. doi: 10.1007/s001200050165.
Since the mid-forties androgen deprivation is regarded the standard treatment of incurable prostate cancer. Antiandrogens can be given either as monotherapy or in combination with bilateral orchidectomy or gonadotropin-releasing-hormone analoga. Recently reports have been published that withdrawal of antiandrogens in patients with hormone-resistant prostate cancer caused reduction of PSA and clinical improvement. Thus, in patients who progress under maximal androgen blockade or antiandrogen-monotherapy the antiandrogen should first be withdrawn and-in case of monotherapy-be replaced by GnRH-analoga. In approximately 30-50% of the cases a reduction of serum-PSA can be expected lasting for approx. 6 months. In some patients an improvement of symptoms and objective remission is observed.
自20世纪40年代中期以来,雄激素剥夺被视为无法治愈的前列腺癌的标准治疗方法。抗雄激素药物既可以作为单一疗法使用,也可以与双侧睾丸切除术或促性腺激素释放激素类似物联合使用。最近有报道称,在激素抵抗性前列腺癌患者中停用抗雄激素药物可导致PSA降低和临床症状改善。因此,对于在最大雄激素阻断或抗雄激素单一疗法下病情进展的患者,应首先停用抗雄激素药物,并且如果是单一疗法,应改用GnRH类似物。在大约30%-50%的病例中,预计血清PSA会降低,持续约6个月。在一些患者中,观察到症状改善和客观缓解。