Early results of LH-RH agonist treatment with or without chlormadinone acetate for hormone therapy of naive localized or locally advanced prostate cancer: a prospective and randomized study. The Prostate Cancer Study Group.
Early results of LH-RH agonist treatment with or without chlormadinone acetate for hormone therapy of naive localized or locally advanced prostate cancer: a prospective and randomized study. The Prostate Cancer Study Group.
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LH-RH 激动剂联合或不联合醋酸氯地孕酮治疗初治局限性或局部晚期前列腺癌激素治疗的早期结果：一项前瞻性随机研究。
DOI：
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发表时间：
2000
影响因子：
2.4
通讯作者：
Y. Aso
中科院分区：
文献类型：
--
作者：
H. Akaza;Y. Homma;K. Okada;M. Yokoyama;N. Moriyama;M. Usami;Y. Hirao;T. Tsushima;Y. Ohashi;Y. Aso
背景
大多数局限性前列腺癌患者和部分局部晚期前列腺癌患者接受根治性前列腺癌切除术。然而，根治性前列腺切除术并不总是适用于这些患者。在这种情况下，初级激素治疗是一种替代治疗选择。我们设计了一项前瞻性随机研究，研究初级激素治疗对此类患者的影响。
方法
共151例T1b、T1c、T2a、T2b或T3a前列腺癌患者进入本研究。将患者随机分为两组，I组单用促黄体生成素激动剂(醋酸亮丙瑞林库，每月3.75 mg)，II组用促黄体生成素激动剂联合醋酸氯地酮100 mg/d。观察两年对血清前列腺特异性抗原水平、无进展生存期和生存期的影响。
结果
没有安排根治性前列腺切除术的原因是手术风险低(38%)、患者意愿(32%)和医生建议(30%)。治疗12周后，两组均有49%的患者完全缓解(CR)。在治疗12周后出现部分缓解(PR)的患者中，I组25%和II组52%在1年后改善为CR(p<；0.05)。II组无进展生存期较长(P<；0.05)。T2b组和T3组的无进展生存率分别为62%(I组)和91%(II组)和43%(I组)和73%(II组)。每组中只有一名患者死于前列腺癌。
结论
如果没有安排根治性前列腺癌切除术，早期初级激素治疗是局部或局部晚期前列腺癌患者的合理治疗选择。至少在2年的观察中，醋酸氯地酮与促黄体生成素受体激动剂有相加作用。
BACKGROUND
The majority of patients with localized and some cases of locally advanced prostate cancer undergo radical prostatectomy. However, radical prostatectomy cannot always be selected for those patients. In this situation, primary hormone therapy is an alternative treatment option. We have designed a prospective randomized study of the effects of primary hormone therapy for such patients.
METHODS
A total of 151 patients with T1b, T1c, T2a, T2b or T3a prostate cancer who were not scheduled for radical prostatectomy were enrolled into this study. Patients were randomly allocated into two groups; Group I received luteinizing hormone-releasing hormone (LH-RH) agonist monotherapy (leuprorelin acetate depot, 3.75 mg monthly) and Group II received LH-RH agonist in combination with chlormadinone acetate (100 mg/day). Effects on serum prostate-specific antigen level, progression-free survival and survival were observed for 2 years.
RESULTS
The reasons why radical prostatectomy was not scheduled were poor risk for surgery (38%), patient's wish (32%) and physician's recommendation (30%). After 12 weeks of treatment, 49% of the patients in both groups showed a complete response (CR). Of the patients showing a partial response (PR) after 12 weeks of treatment, 25% in Group I and 52% in Group II improved to CR 1 year later (p<0.05). Group II showed a longer progression-free survival (p <0.05). Progression-free survival rates were 62% (Group I) and 91% (Group II) in T2b patients and 43% (Group I) and 73% (Group II) in T3 patients. Only one patient in each group died from prostate cancer.
CONCLUSIONS
Early primary hormone therapy is a reasonable treatment option for localized or locally advanced prostate cancer patients if radical prostatectomy was not scheduled. Chlormadinone acetate showed an additive effect with LH-RH agonist, at least in 2 years' observation.
前列腺特异性抗原时代无症状晚期前列腺癌的雄激素剥夺疗法：泌尿科医师信仰和实践的全国调查。
DOI：
10.1016/s0022-5347(01)63223-3
发表时间：
1998
期刊：
The Journal of urology
影响因子：
--
作者：
Wasson,JH;FowlerJr,FJ;Barry,MJ
通讯作者：
Barry,MJ