荷尔蒙疗法治疗前列腺癌的疗效及副作用：来自日本的经验和观点

目前，随着对前列腺癌去势抵抗机制的诠释，各种新型抗雄激素及雄激素生物合成抑制剂相继被开发出来了。相信这些新药物会改善激素疗法。另一方面，越来越多的人却对激素疗法提出质疑，如可能诱发心血管疾病等不良反应等。鉴于激素疗法对白种人和亚洲人的疗效及不良反应存在种族差异，本文综述了日本激素疗法治疗前列腺癌的经验。首先，本研究发现基础的激素疗法能长期控制某些局部前列腺癌患者的病情，还发现接受激素疗法的患者生活质量比之前预想的要好。激素疗法作为一种新辅助治疗和辅助治疗方法，对患有高危前列腺癌、局部晚期前列腺癌并接受前列腺根治术及放疗的患者十分有效。激素疗法作为辅助疗法的疗效还有待进一步临床试验证实。本研究还发现，日本心血管疾病死亡人数中，接受过激素疗法的患者并不比普通人群多。不过，即便是在日本，由于患者生活方式的改变可能会增加对激素疗法不良反应的易感性，因此还应努力减少副作用，这对糖尿病等内分泌和代谢性疾病的管理必不可少。预计未来将开发靶向治疗列腺癌的新型激素药物，如选择性激素受体调节剂。

Understanding prostate-specific antigen dynamics in monitoring metastatic castration-resistant prostate cancer： implications for clinical practice

Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer （CRPC） has changed the outlook for this group of patients with improvements in progression-free survival and overall survival. Physicians often diagnose the progression of prostate cancer using serum prostate-specific antigen （PSA）. However, serum PSA is not always correlated with the clinical status in CRPC. To evaluate the PSA dynamics with greater precision, understanding of the control of PSA and of the mechanisms of development of CRPC is needed. Moreover, it is necessary to use new hormonal therapies with an appropriate timing to optimally improve the prognosis and the QOL of the patients. In the present review, we ascertain the PSA dynamics and the mechanisms of the development of CRPC to assist in optimal utilization of the new treatments for mCRPC.