Efficacy of Alternative Antiandrogen Therapy for Prostate Cancer That Relapsed after Initial Maximum Androgen Blockade
Efficacy of Alternative Antiandrogen Therapy for Prostate Cancer That Relapsed after Initial Maximum Androgen Blockade
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DOI：
10.4111/kju.2011.52.7.461
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发表时间：
2011-07-01
期刊：
影响因子：
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通讯作者：
Jung, Tae Young
中科院分区：
文献类型：
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作者：
Choi, Joon Il;Kim, Yun Beom;Jung, Tae Young
目的：我们评估了二线最大雄激素阻断（MAB）的有效性与替代抗雄激素治疗后复发的患者初始MAB.Materials和方法：我们回顾性分析了47例前列腺癌复发后初始MAB，包括手术或药物去势联合抗雄激素，从1998年1月至2009年12月。当血清前列腺特异性抗原（PSA）水平连续三次升高时，我们停用抗雄激素，然后给予替代抗雄激素。对7例患者进行了抗雄激素戒断综合征（AWS）评估。根据血清PSA水平评估二线MAB的疗效，将应答细分为PSA较基线PSA降低>= 50%和< 50%。结果：在32例患者（68.1%）中观察到PSA降低。其中，23例（48.9%）PSA降低≥ 50%，平均缓解持续时间为13.4 +/- 5.4个月。9例（19.2%）患者达到PSA降低< 50%，平均缓解持续时间为12.2 ± 6.2个月。PSA降低>= 50%组、PSA降低< 50%组和PSA升高组一线MAB后至PSA最低值的时间分别为15.6 +/- 12.9个月、11.8 +/- 6.0个月和8 +/- 6.5个月。也就是说，它是显着更长的反应组（p=0.038）。结论：二线MAB使用替代抗雄激素是一种有效的治疗选择细胞毒化疗后复发的患者初始MAB。
Purpose: We evaluated the effectiveness of second-line maximum androgen blockade (MAB) with an alternative antiandrogen in patients who relapsed after initial MAB.Materials and Methods: We retrospectively analyzed 47 patients with prostate cancer who relapsed after initial MAB, including surgical or medical castration combined with antiandrogens, from January 1998 to December 2009. When the serum prostate-specific antigen (PSA) level was increased on three consecutive occasions, we discontinued the antiandrogen and then administered an alternative antiandrogen. Seven patients were assessed for antiandrogen withdrawal syndrome (AWS). The effect of the second- line MAB was evaluated by the serum PSA level, and response was subdivided into >= 50% and < 50% PSA reductions from the baseline PSA at the start of second-line MAB.Results: PSA reduction was observed in 32 patients (68.1%). Among them, 23 (48.9%) achieved >= 50% PSA reductions with a mean response duration of 13.4 +/- 5.4 months. Nine (19.2%) patients reached < 50% PSA reductions with a mean response duration of 12.2 +/- 6.2 months. The time to nadir PSA level after first-line MAB in the >= 50% PSA reduction group, < 50% PSA reduction group, and PSA elevation group was 15.6 +/- 12.9 months, 11.8 +/- 6.0 months, and 8 +/- 6.5 months, respectively. That is to say, it was significantly longer in the responder groups (p=0.038).Conclusions: Second-line MAB using an alternative antiandrogen is an effective treatment option before cytotoxic chemotherapy in patients who relapse after initial MAB.