Hormone-refractory Prostate Cancer.
Hormone-refractory Prostate Cancer.
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DOI：
10.1007/s11864-002-0008-1
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发表时间：
2002-10-01
影响因子：
4.3
通讯作者：
Small, Eric J
中科院分区：
文献类型：
--
作者：
Rini, Brian I;Small, Eric J
五十多年来，晚期前列腺癌的首选治疗方法是通过药物或手术去势来抑制雄激素的产生。然而，所有接受雄激素剥夺治疗的患者最终都会发展成抵抗性疾病，表现为前列腺特异性抗原水平升高，影像检查显示疾病进展，最终症状恶化。激素难治性前列腺癌(HRPC)患者的治疗曾被认为是一项相对徒劳的努力，但随着新疗法的发展，在过去的几年里已经发生了显著的变化。最重要的新治疗策略之一是在初次雄激素剥夺失败后进行二次激素调控；这种方法是建立在认识到HRPC是一种异质性疾病的基础上。一些患者可能会对替代激素干预有反应，尽管存在去势水平的睾酮。此外，化疗方案的应用为HRPC患者提供了可行的治疗选择。
For more than five decades, the preferred treatment for advanced prostate cancer has been suppression of androgen production by medical or surgical castration. However, all patients treated with androgen deprivation eventually develop resistant disease as manifested by increasing prostate-specific antigen levels, progressive disease on imaging studies, and ultimately worsening symptoms. The treatment of patients with hormone-refractory prostate cancer (HRPC), once thought to represent a relatively futile endeavor, has changed significantly in the past several years with the development of new therapeutics. One of the most important new treatment strategies involves secondary hormonal manipulation after the failure of primary androgen deprivation; this approach is predicated on the recognition that HRPC is a heterogenous disease. Some patients may respond to alternative hormonal interventions despite the presence of castrate levels of testosterone. Furthermore, the application of chemotherapeutic regimens has provided viable treatment options for patients with HRPC.