Hormone therapy for prostate cancer - Immediate initiation
Hormone therapy for prostate cancer - Immediate initiation
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DOI：
10.1159/000139878
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发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Schrader, M.
中科院分区：
文献类型：
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作者：
Schostak, M.;Miller, K.;Schrader, M.
虽然激素治疗被广泛用于前列腺癌的管理，其启动的最佳时机仍然是一个有争议的问题。过去几十年的许多研究报告了早期开始治疗后的小但显著的生存益处和临床症状发展的明显延迟。患有局限性或局部晚期前列腺癌并且不适合根治性前列腺切除术或放疗等治疗方案的患者最好仅通过激素治疗进行管理，这已经被认为是转移性疾病的最佳治疗方法。另一方面，长期激素治疗会使患者面临大量不良反应的风险，包括肌肉萎缩、慢性疲劳和骨质疏松症。预后和生活质量因素也对治疗决策有影响，特别是在最有可能从延长剩余寿命中获益的患者中。根据现有的证据，早期激素治疗可能被推荐用于低分化肿瘤或晚期疾病的男性，以及那些不常被医生看到的男性。这种管理可以防止前列腺癌转移到骨骼，在那里治疗变得非常困难，治愈甚至长期控制疾病是例外。版权所有（C）2008 S. Karger AG，巴塞尔。
Although hormone therapy is widely used in the management of prostate cancer, the optimal timing of its initiation remains a matter of debate. Many studies of the last decades have reported a small but significant survival benefit and a clear delay in the development of clinical symptoms after early initiation of therapy. Patients who have localized or locally advanced prostate cancer and are not suitable for curative options like radical prostatectomy or radiotherapy can best be managed by hormone therapy alone, which has already been recognized as the optimal treatment for metastatic disease. On the other hand, long-term hormone treatment will expose the patient to the risk of substantial adverse effects, including muscle wasting, chronic fatigue and osteoporosis. Prognostic and quality-of-life factors also have an impact on the treatment decision, particularly in patients most likely to profit from an extension of the remaining life span. Based on available evidence, early hormone therapy may be recommended for men with poorly differentiated tumors or advanced disease and for those infrequently seen by their physicians. This management can prevent prostate cancer from migrating to the bones, where treatment becomes extremely difficult and cure or even long-term control of the disease is an exception. Copyright (C) 2008 S. Karger AG, Basel.