ISSN: 1305-3876
Hakkında: Özel sayılar şeklinde yayınlanır.
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Recent Progress In Hormonal Therapy For Advanced Prostate Cancer
Dr. Timothy J. DASKIVICH,a Dr. William K. OHa
aDana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA
Purpose of Review: Primary androgen deprivation therapy and secondary hormonal therapy remain the cornerstones of treatment for advanced prostate cancer. This review outlines the basic evidence for use of hormonal therapy while highlighting major research developments made in the past year.
Recent Findings: Recent research on androgen deprivation therapy has suggested that patients with high-risk features may have longer metastasis-free survival with early initiation of androgen deprivation therapy. Fracture risk has been shown to be significantly increased in patients on androgen deprivation therapy and is correlated with duration of treatment. In the treatment of androgenindependent prostate cancer, oral premarin has been shown to induce of prostate specific antigen responses more than 50% in 32% of patients, though thromboembolism remains a risk despite prophylactic lowdose warfarin. Transdermal estradiol has been associated with virtually no cardiovascular toxicity, but induced of prostate specific antigen responses more than 50% in only 12.5% of patients. Clinical studies of nilutamide, flutamide, and ketoconazole have further clarified efficacyof these secondary hormonal treatments.
Summary: Optimal timing of androgen deprivation therapy awaits the results of randomized trials, but available evidence indicates that patients with high-risk features may benefit from early androgen deprivation therapy. New estrogen-based therapies have shown promising efficacy in the treatment of androgen-independent prostate cancer, with significantly less cardiovascular toxicity than traditional estrogens.Keywords: Androgen antagonists, estrogens,
hormonal antineoplastic agents,
hormone-dependent neoplasms, prostatic neoplasmsTurkiye Klinikleri J Surg Med Sci 2006, 2(38):53-58
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