LHRH analogue的轉換對於晚期攝護腺癌的治療效果
沈元琦、康智雄、江博暉
高雄長庚紀念醫院泌尿科
Efficacy of switching therapy of luteinizing hormone-releasing hormone analogue for advanced prostate cancer
Yuan-Chi Shen、Chih- Hsiung Kang、Po-Hui Chiang
Department of Urology, Kaohsiung Chang Gung Memorial Hospital
Purpose:
To determine the efficacy of switching therapy with a second LHRH analogue after PSA progression for advanced prostate cancer.
Materials and Methods:
Between December 2005 to September 2013, there were 200 patients with nodal positive, metastatic prostate cancer or disease progression after definite treatment receiving continuous LHRH analogues therapy with monthly Depot leuprorelin(sc) acetate 3.75mg/vial (LA) or Gorserelin acetate(sc) 3.6mg /vial (GA). If the patients had castration resistant prostate cancer, the treatment choice of switching therapy (LA to GA or GA to LA) before entering chemotherapy was given.The LH, testosterone level and PSA change were recorded.
Results:
127 patients receiving LA as initial ADT therapy and the other 73 patients were in GA therapy. A total of 92 patients (54 patients got LA to GA and 38 got GA to LA) got LHRH analogue switching therapy. The effect of LH and testosterone reducing before and after switching therapy was comparable between two groups and the increasing PSA level after three-months treatment was seen in both groups (median PSA: 15.7 to 67.7ng/ml in LA to GA group and 15.2 to 71.4ng/ml in GA to LA group).
Conclusion:
Switching therapy for patients with PSA progression after ADT has no efficacy of further PSA decrease.