전립선암의 치료에서 간헐적 안드로젠 차단요법의 초기경험

Abstract

The increasing interest in exploring the use of intermittent androgen deprivation in prostate cancer has prompted a retrospective review of patients who elected to stop treatment. Observations were made on 10 patients. Treatment was initiated with goserelin acetate with flutamide or goserelin acetate alone and continued until a serum PSA nadir was observed. medication was then withheld until the serum PSA increased to a median value between 10 and 20 ng/ml. The first two treatment cycles lasted 12.5 and 14 months, with mean time off therapy of 5.1 and 7 months and an overall mean percentage time off therapy of 41% and 50%, respectively. The mean time to achieve a nadir level of serum PSA was 5.7 months in cycle 1 and 4.3 months in cycle 2. The off treatment in both cycles was associated with an improvement in sense of well-being and the recovery of libido. Prostate cancer is amenable to control by intermittent androgen suppression. This approach affords an improved quality of life when the patient is off therapy. It also results in reduced toxicity and cost of treatment. Whether tumor progression is affected in beneficial or adverse way remains to be studied in a randomized, prospective study.