Androgen deprivation therapy for asymptomatic advanced prostate cancer in the prostate specific antigen era: a national survey of urologist beliefs and practices.
Androgen deprivation therapy for asymptomatic advanced prostate cancer in the prostate specific antigen era: a national survey of urologist beliefs and practices.
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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
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Barry,MJ
中科院分区：
文献类型：
--
作者：
Wasson,JH;FowlerJr,FJ;Barry,MJ
目的去雄激素治疗前列腺癌无症状性骨骼转移是有争议的。然而，到1995年，使用注射方式剥夺雄激素已成为医疗保险向医生报销的第13大类。泌尿科医生对雄激素剥夺的态度在多大程度上导致了这种增长？材料和方法1995年向582名每周至少工作20小时的美国泌尿科医生邮寄了一份调查，询问当前列腺特异性抗原(PSA)水平在初级治疗(手术或放射治疗)后上升时，是否使用雄激素剥夺治疗。他们还被问及是否相信雄激素剥夺能为无症状的C期和D期疾病患者提供生存益处。在受访者中，68%的人报告说，对于前列腺癌根治术后PSA新升高或持续升高的男性，他们至少有一半的时间建议剥夺雄激素。大多数(81%)认为雄激素剥夺对C期疾病有生存益处的泌尿科医生说他们开了它，但超过一半(53%)不相信这种治疗效果的人也说他们仍然开这种药。结论尽管缺乏关于这种方法的益处的信息和他们自己相互矛盾的信念，许多泌尿科医生仍然倾向于给PSA升高或升高的患者开雄激素剥夺。
PurposeThe use of androgen deprivation for prostate cancer without symptomatic metastases to the skeleton is controversial. However, by 1995 the use of medical androgen deprivation by injection was the thirteenth largest category of physician reimbursement by Medicare. To what degree do urologist attitudes towards androgen deprivation account for this growth?Materials and MethodsA survey was mailed to 582 United States urologists practicing at least 20 hours per week in 1995 which asked about use of androgen deprivation therapy when prostate specific antigen (PSA) levels rise after primary therapy (surgery or radiation). They were also asked whether they believed androgen deprivation provided a survival benefit for patients with asymptomatic stages C and D disease.ResultsThe response rate was 68%. Of the respondents 68% reported that they recommend androgen deprivation at least half of the time for men whose PSA is newly or persistently elevated following radical prostatectomy. Most (81%) urologists who believe that androgen deprivation offers a survival benefit for stage C disease said they prescribed it but more than half (53%) who do not believe in the efficacy of this treatment also said they still prescribe it.ConclusionsMany urologists maintain an inclination to prescribe androgen deprivation for a rising or elevated PSA despite the absence of information about the benefit of this approach and their own conflicting beliefs.
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