Clinical efficacy of alternative antiandrogen therapy in Japanese men with relapsed prostate cancer after first-line hormonal therapy
Clinical efficacy of alternative antiandrogen therapy in Japanese men with relapsed prostate cancer after first-line hormonal therapy
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DOI：
10.1111/j.1442-2042.2007.01698.x
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发表时间：
2007-02-01
影响因子：
2.6
通讯作者：
Miki, Tsuneharu
中科院分区：
文献类型：
--
作者：
Okihara, Koji;Ukimura, Osamu;Miki, Tsuneharu
背景：为证实替代抗雄激素疗法(AAT)对一线激素治疗后复发的日本前列腺癌患者的疗效。方法：共纳入80例经一线激素治疗后血清前列腺特异性抗原(PSA)持续进展的患者(单用促黄体生成素释放激素激动剂21例，联合抗雄激素阻断治疗59例)。我们评估了抗雄激素戒断综合征(AWS)的阳性率、二线和三线AAT的PSA应答以及AAT的病因特异性生存率。结果：一线治疗后AWS总阳性率为33%，二线治疗后AWS阳性率为7%。一线PSA反应与AWS阳性之间无相关性。在10例AWS阳性和20例AWS阴性患者中，二次抗雄激素治疗有效率分别为50%和60%。PSA在二线和三线治疗中的阳性反应率分别为51%和13%。二线治疗从类固醇到非类固醇、从非类固醇到非类固醇、从非类固醇到类固醇的有效率分别为83%、43%和14%。二线应答者的特定原因存活率明显好于无应答者。结论：有相当数量的患者发现二线AAT适度有效。氟他胺作为日本男性患者使用比卡鲁胺复发治疗的替代抗雄激素有效。
Background: To confirm the effectiveness of alternative antiandrogen therapy (AAT) in Japanese patients with prostate cancer relapse after first-line hormonal therapy.Methods: A total of 80 patients who had successive serum prostate-specific antigen (PSA) progression after first-line hormonal therapy (luteinizing hormone-releasing hormone agonist alone: 21 cases; combined antiandrogen blockade therapy: 59 cases) were enrolled. We evaluated the positive ratio of antiandrogen withdrawal syndrome (AWS), the PSA responses with second- and third-line AAT, and cause-specific survival in terms of the effectiveness of AAT.Results: The overall positive AWS ratio after first-line therapy was 33%, while that after second-line therapy was 7%. There was no correlation between the first-line PSA response and the positive AWS. Of the 10 positive and the 20 negative AWS cases, secondary antiandrogen administration was effective in 50% and 60% of cases, respectively. The positive PSA responders at second- and third-line therapy were 51% and 13%, respectively. For second-line therapy, the effective rates from steroidal to non-steroidal, from non-steroidal to non-steroidal antiandrogen, and from non-steroidal to steroidal were 83%, 43%, and 14%, respectively. The cause-specific survival of the second-line responders was significantly better than that of the non-responders.Conclusion: There was a substantial number of patients who found second-line AAT to be modestly effective. Flutamide was effective as an alternative antiandrogen for the patients' relapse treatment with bicalutamide in Japanese men.