Shimada M, Uchida H, Kasahara T, Fuji K, Ogawa Y, Yoshida H, Hamajima T, Matsuda N, Ikeuchi T, Kai Y, Hiramori M, Hoshino M, Inoue K, Higaki Y
Department of Urology, Showa University, School of Medicine.
Hinyokika Kiyo. 1998 Jul;44(7):525-32.
Twenty-four previously untreated patients with a diagnosis of prostatic cancer were treated with chlormadinone acetate (CMA) alone (100 mg/day) for 4 weeks, and luteinizing hormone-releasing hormone analogue (LH-RHa) was added for the next 24 weeks. Marked decreases in blood LH, testosterone (T), prostate specific antigen (PSA), gamma-seminoprotein (gamma-Sm), and prostatic acid phosphatase (PAP) were observed after a single dose of CMA. T levels were significantly increased 3 days after the initial dose of LH-RHa, and did not return to the pretreatment level. There were no significant increases in any of the markers, nor were there any flare-up cases. Triglyceride levels, which were slightly elevated before the start of treatment, were significantly decreased 24 weeks after the completion of combined therapy. PSA was evaluated as partial response (PR) or better in 86.7% of the patients. Overall evaluation showed PR or better in 75.0% of the patients. These findings suggest that prior administration of CMA followed by combined administration with LH-RHa is useful in the treatment of prostatic cancer. No negative effects on lipid metabolism were observed at any time during the treatment period.
24例初治前列腺癌患者先单独使用醋酸氯地孕酮(CMA,100毫克/天)治疗4周,随后在接下来的24周加用促黄体生成激素释放激素类似物(LH-RHa)。单次给予CMA后,血液中促黄体生成素(LH)、睾酮(T)、前列腺特异性抗原(PSA)、γ-精浆蛋白(γ-Sm)和前列腺酸性磷酸酶(PAP)均显著下降。首次给予LH-RHa 3天后,T水平显著升高,且未恢复至治疗前水平。各标志物均无显著升高,也无任何病情突然加重的病例。治疗开始前略有升高的甘油三酯水平在联合治疗结束24周后显著下降。86.7%的患者PSA评估为部分缓解(PR)或更好。总体评估显示75.0%的患者为PR或更好。这些结果表明,先给予CMA,随后联合LH-RHa给药对前列腺癌治疗有效。治疗期间任何时候均未观察到对脂质代谢的负面影响。