摘要

This is the final analysis of EORTC GU Group Trial 30843 in which the treatment of advanced, metastatic prostate cancer with a combination of the LHRH agonist buserelin (nasal spray) and cyproterone acetate (Androcur), either continuously of only during the first 2 weeks, was compared with orchidectomy. There was no significant difference between the three arms as far as response rate, time to progression (subjective and objective) and duration of survival are concerned. Retrospective stratification according to the most important prognostic factors did not change the conclusions. Possible reasons for the difference with trial 30853, which used the same entry criteria but compared goserelin and flutamide with orchidectomy, are discussed. Reasons for using cyproterone acetate in combination treatment are the prevention of flare of the disease after LHRH agonists only and the prevention/reduction of toxicity in the form of hot flushes.

译文

这是 EORTC GU 小组试验 30843 的最终分析，其中使用 LHRH 激动剂 buserelin (鼻喷雾剂) 和醋酸环丙孕酮 (雄激素) 的组合治疗晚期转移性前列腺癌, 与兰花切除术相比，要么仅在头 2 周内连续进行。就反应率、进展时间 (主观和客观) 和生存时间而言，三组之间没有显著差异。根据最重要的预后因素进行回顾性分层没有改变结论。讨论了与试验 30853 不同的可能原因，该试验使用相同的进入标准，但将戈舍瑞林和氟他胺与兰花切除术进行了比较。在联合治疗中使用醋酸环丙孕酮的原因是仅在 LHRH 激动剂后预防疾病的爆发，以及以热潮红的形式预防/减少毒性。