抗雄激素撤除综合征

The antiandrogen withdrawal syndrome

目的 探讨抗雄激素撤除综合征的临床特点及意义。 方法 对 2 4例前列腺癌 (C期10例 ,D期 14例 )采用联合雄激素阻断 (双侧睾丸切除 +氟他胺 )治疗。 7～ 3 6个月后 ,因病变进展而停用氟他胺。每 2～ 4周检测血清PSA值并观察临床症状变化。 结果 8例患者血清PSA值较停药前下降 ,平均下降 75 % ,其中下降 >5 0 %者 6例。 4例临床症状有改善 ,2例前列腺结节较前缩小。平均缓解时间为 4 .3个月。 结论 当联合雄激素阻断治疗的晚期前列腺癌出现激素拮抗性时 。

Objective To evaluate the occurrence of antiandrogen withdrawal syndrome in patients with advanced prostate cancer treated with combined androgen blockade. Methods 24 cases of advanced prostate cancer (10 in stage C and 14 in stage D) were retrospectively studied. All the patients have been treated with combined androgen blockade (bilateral orchiectomy and flutamide). After initial beneficial response to hormonal therapy (duration 7 to 36 months), the disease became progressing.Flutamide was then discontinued. Serum prostate specific antigen (PSA) levels and symptoms alterations were observed. Results Following withdrawal of flutamide, 8 patients showed a decline in PSA (mean 75%).In 6 the PSA declined more than 50%. Clinical symptoms improved in 4 patients and the prostate mass became smaller in 2. The mean duration of improvement was 4.3 months. Conclusions In patients with hormone refractory prostate cancer after initial combined androgen blockade, a trial of 'antiandrogen withdrawal' is a reasonable therapeutic management prior to other more toxic therapies.