Noguchi K, Harada M, Masuda M, Takeda M, Kinoshita Y, Fukushima S, Miyai K, Fukuoka H, Hosaka M
Department of Urology, Yokohama City University School of Medicine, Yokohama, Japan.
Int J Urol. 1998 Sep;5(5):466-70. doi: 10.1111/j.1442-2042.1998.tb00389.x.
A multicenter, clinical trial investigated the effects of an interruption of antiandrogen therapy on subjective and objective clinical parameters in patients with benign prostatic hypertrophy (BPH).
Patients were given antiandrogen therapy with allylestrenol (50 mg/day) for 16 weeks. The medication was then withheld and the patients were carefully monitored for an additional 16 weeks. There were 34 BPH patients ranging in age from 55 to 82 years (mean, 66.1 years). The efficacy of allylestrenol was evaluated by its effects on prostate volume, maximum urinary flow rate (MFR), and symptom scores at the end of 16 weeks of treatment and then again at 32 weeks (16 weeks after cessation of therapy).
Allylestrenol was effective in the treatment of BPH, and was still effective 16 weeks after the cessation of medication. The prostate volume did not change after treatment cessation nor did the total symptom score, but the MFR reversed to the pretreatment level. Serum testosterone (1.95 ng/mL), dihydrotestosterone, and gonadotropin levels decreased on therapy, but were completely reversed by the end of this study. A prostate needle biopsy revealed that after 16 weeks without therapy, some glands showed regressive glandular changes, while some glands showed slight hyperplastic changes of the secretory epithelium. Eight per cent of patients complained of loss of libido during this study.
Allylestrenol is an effective and safe medical treatment for patients with symptomatic BPH. Hormonal and histopathologic findings suggest that the prostate gland may regrow after discontinuation of medication.
一项多中心临床试验研究了抗雄激素治疗中断对良性前列腺增生（BPH）患者主观和客观临床参数的影响。
患者接受烯丙雌醇（50毫克/天）抗雄激素治疗16周。然后停药，并对患者进行额外16周的密切监测。共有34例BPH患者，年龄在55岁至82岁之间（平均66.1岁）。通过烯丙雌醇在治疗16周结束时以及停药16周后（即32周时）对前列腺体积、最大尿流率（MFR）和症状评分的影响来评估其疗效。
烯丙雌醇对BPH治疗有效，停药16周后仍有效果。停药后前列腺体积和总症状评分均未改变，但MFR恢复到治疗前水平。治疗期间血清睾酮（1.95纳克/毫升）、双氢睾酮和促性腺激素水平下降，但在本研究结束时完全恢复。前列腺穿刺活检显示，在停药16周后，一些腺体出现退行性腺性改变，而一些腺体的分泌上皮出现轻度增生性改变。在本研究期间，8%的患者抱怨性欲减退。
烯丙雌醇对有症状的BPH患者是一种有效且安全的药物治疗。激素和组织病理学结果表明，停药后前列腺可能会再生。
