A review of studies of hormonal adjuvant therapy in prostate cancer

被引:32
作者
Wirth, M [1 ]
Froehner, M [1 ]
机构
[1] Tech Univ Dresden, Klinikum Carl Gustav Carus, Dept Urol, Klin & Poliklin Urol, D-01307 Dresden, Germany
关键词
early prostate cancer; adjuvant therapy; radical prostatectomy; radiotherapy; LH-RH agonists; antiandrogens; bicalutamide; orchiectomy; prognostic factors;
D O I
10.1159/000052338
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
There is increasing interest in the use of adjuvant hormonal therapies, which are given after the resection or destruction of all gross disease, in early-stage prostate cancer, as a significant proportion of patients experience progression and/or die from the disease despite undergoing therapy with curative intent. Several retrospective studies suggest that adjuvant hormonal therapy may improve long-term outcome after radical surgery in men with positive lymph nodes, although this approach has yet to be studied in a prospective setting. No studies of adjuvant therapy for patients with extracapsular extension at surgery have been completed, but in an interim analysis of an open controlled trial, adjuvant flutamide significantly improved progression-free survival at 4 years. Three prospective studies in the radiotherapy setting have shown that adjuvant luteinizing hormone-releasing hormone (LH-RH) agonist therapy significantly improves progression-free and/or overall survival. Future studies need to define patient subgroups who will benefit most from adjuvant therapy. The side effects of the different therapeutic options also need to be compared, It is hoped that many of the outstanding questions concerning adjuvant hormonal therapy will be answered by the ongoing Bicalutamide Early Prostate Cancer Programme.
引用
收藏
页码:14 / 19
页数:6
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