Advertisement

Klassische Methoden des Androgenentzugs in der Therapie des fortgeschrittenen Prostatakarzinoms

  • H. Schulze
  • Th. Senge

Zusammenfassung

Das Prostatakarzinom ist die zweit- bzw. dritthäufigste Krebstodesursache aller Männer in den westlichen Industriestaaten (Silverberg 1982). In der Bundesrepublik Deutschland ist das Prostatakarzinom mit über 8000 Todesfällen/Jahr die dritthäufigste Krebstodesursache. Für Männer, älter als 55 Jahre ist das Prostatakarzinom sogar die führende Krebstodesursache. Neben dieser hohen Mortalitätsrate weist das Prostatakarzinom auch eine hohe jährliche Inzidenzrate auf. In den Vereinigten Staaten beispielsweise macht das Prostatakarzinom 17% aller jährlich neu entdeckten Krebserkrankungen bei Männern aus (Silverberg 1982). Umgerechnet auf die derzeitige Lebenserwartung bedeutet dies, daß jeder 20. weiße Amerikaner ein klinisch manifestes Prostatakarzinom entwickeln wird (Seidmann et al. 1978). Die Inzidenzrate bei amerikanischen Farbigen liegt sogar noch höher. Statistisch wird sich bei jedem 10. zu Lebzeiten ein klinisch manifestes Prostatakarzinom entwickeln (Mettlin 1983). Weniger als 1% aller klinisch manifesten Prostatakarzinome werden vor dem 50. Lebensjahr diagnostiziert. Die Inzidenz des Prostatakrebses steigt dann aber mit zunehmendem Lebensalter rapide und schneller an als die jeder anderen Krebsform (Young et al. 1981). Aus diesen epidemiologischen Daten ergibt sich, daß mit der allgemein zunehmenden Lebenserwartung die Inzidenz des klinisch manifesten Prostatakarzinoms weiter ansteigen wird, wie sie auch in den letzten 50 Jahren ständig angestiegen ist (Devesa u. Silverman 1978). Hieraus leiten sich statistische Analysen ab, nach denen das Prostatakarzinom innerhalb der nächsten 20–25 Jahre die häufigste Krebstodesursache aller Männer sein wird.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Adler A, Burger H, Davis J, Dulmanis A, Hudson B, Sarfaty G, Straffon W (1968) Carcinoma of prostate: Response of plasma luteinizing hormone and testosterone to oestrogen therapy. Br Med J 1: 28CrossRefGoogle Scholar
  2. Baba S, Janetschek G, Pollow K, Hahn K, Jacobi GH (1982) The effects of clorotrianisene (Tace) on kinetics of 3H-testosterone metabolism in patients with carcinoma of the prostate. Br J Urol 54: 393PubMedCrossRefGoogle Scholar
  3. Bailar JC, Byar DP, Veterans Administration Cooperative Urological Research Group (1970)Google Scholar
  4. Estrogen Treatment for cancer of the prostate. Cancer 26:257Google Scholar
  5. Baker HW, Burger HG, de Kretser DM, Hudson B, Straffon WG (1973) Effects of synthetic oral estrogens in normal men and patients with prostatic carcinoma. Lack of gonadotrophin suppression by chlorotrianisene. Clin Endocrinol 2: 297CrossRefGoogle Scholar
  6. Beck PH, McAnnich JW, Goebel JL, Stutzman RE (1978) Plasma testosterone in patients receiving diethylstilbestrol. Urology 11: 157PubMedCrossRefGoogle Scholar
  7. Blackard CE, Byar DP, Jordan WP jr, The Veterans Administration Cooperative Urological Research Group (1973) Orchiectomy for advanced prostatic carcinoma. A réévaluation. Urology 1: 553Google Scholar
  8. Brendler H, Prout GR jr (1962) A cooperative group study of prostatic cancer: Stilbestrol versus placebo in advanced progressive disease. Cancer Chemother Rep 16: 323PubMedGoogle Scholar
  9. Catalona WJ, Scott WW (1986) Carcinoma of the prostate. In: Walsh PC, Gittes RF, Perlmutter AD, Stamey TA (eds) Campbell’s Urology, 5th ed, WB Saunders, Philadelphia, S 1463–1534Google Scholar
  10. Clark P, Houghton L (1977) Subcapsular orchiectomy for carcinoma of the prostate. Br J Urol 49: 419PubMedCrossRefGoogle Scholar
  11. Devesa S, Silverman DT (1978) Cancer incidence and morbidity trends in the United States: 1935–1974. J Natl Cancer Inst 60: 545PubMedGoogle Scholar
  12. Elder JS, Gibbons SRP (1985) Results of trends of the USA National Prostatic Cancer Project. Prog Clin Biol Res 185 (A): 221Google Scholar
  13. Ellis WJ, Isaacs JT (1985) Effectiveness of complete versus partial androgen withdrawal therapy for the treatment of prostatic cancer as studied in the Dumming R-3327 system of rat prostatic adenocarcinoma. Cancer Res 45: 6041PubMedGoogle Scholar
  14. Farnsworth W, Gonder MJ (1977) Prolactin and prostate cancer. Urology 10: 33PubMedCrossRefGoogle Scholar
  15. Glashan RW, Robinson MRG (1981) Cardiovascular complications in the treatment of prostatic carcinoma. Br J Urol 53: 624PubMedCrossRefGoogle Scholar
  16. Huggins C, Clark PJ (1940) Quantitative studies of prostatic secretion. II. The effect of castration and of estrogen injection on the normal and on the hyperplastic prostatic glands of dogs. J Exp Med 72: 747PubMedCrossRefGoogle Scholar
  17. Huggins C, Hodges CV (1941) Studies on prostatic cancer. I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Res 1: 293Google Scholar
  18. Huggins C, Stevens RE, Hodges CV (1941) Studies on prostatic cancer. II. The effects of castration on advanced carcinoma of the prostate gland. Arch Surg 43: 209CrossRefGoogle Scholar
  19. Huggins C, Scott WW, Hodges CV (1941) Studies on prostatic cancer. III. The effects of fever, desoxycorticosterone and of estrogen on clinical patients with metastatic carcinoma of the prostate. J Urol 46: 997Google Scholar
  20. Isaacs JT, Coffey DS (1981) Adaption vs. selection as the mechanism responsible for the relapse of prostatic cancer to androgen ablation as studied in the Dumming R-3327-H adenocarcinoma. Cancer Res 41: 5070PubMedGoogle Scholar
  21. Jacobi GH, Altwein JE (1978) Bromocriptin, ein neues therapeutisches Prinzip beim Prostata-Adenom und -Karzinom. Dt med Wschr 103: 827CrossRefGoogle Scholar
  22. Labrie F, Dupont A, Belanger A (1985) Complete androgen blockade for the treatment of prostate cancer. In: DeVita VT, Hellman S, Rosenberg S (Hrsg) Important advances in oncology 1985. J.B. Lippincott, Philadelphia, S 193ffGoogle Scholar
  23. Lepor H, Ross A, Walsh PC (1982) The influence of hormonal therapy on survival of men with advanced prostatic cancer. J Urol 128: 335PubMedGoogle Scholar
  24. The Leuprolide Study Group (1984) Leuprolide versus diethylstilbestrol for metastatic prostatic cancer. N Engl J Med 311: 1281CrossRefGoogle Scholar
  25. Lukkarinen O, Hammond GL, Kontturi M, Vikko R (1981) Long-term effects of endocrine treatment on serum pituitary hormones in advanced prostatic carcinoma patients. Scand J Urol Nephrol 15: 207PubMedCrossRefGoogle Scholar
  26. Mackler MA, Liberti JP, Smith MJV, Koonth WW jr, Prout GR jr (1972) The effect of orchiectomy and various doses of stilbestrol on plasma testosterone levels in patients with carcinoma of the prostate. Invest Urol 9: 423PubMedGoogle Scholar
  27. Mettlin G (1983) Epidemiology of prostate cancer in different population groups. Clin Oncol 2: 287Google Scholar
  28. Murphy GP, Beckley S, Brady MF, Chu TM, deKernion JB, Dhabuwala Ch, Gaeta JF, Gibbons RP, Loening SA, McKiel ChF, McLeod DG, Pontes JE, Prout GR, Scardino PT, Schlegel JU, Schmidt JD, Scott WW, Slack NH, Soloway MS (1983) Treatment of newly diagnosed metastatic prostate cancer patients with chemotherapy agents in combination with hormones versus hormones alone. Cancer 51: 1264–1272PubMedCrossRefGoogle Scholar
  29. Nesbit RM, Plumb RT (1946) Prostatic carcinoma: A follow-up on 795 patients treated prias to endocrine era and patients treated with endocrine therapy. Surgery 20: 263PubMedGoogle Scholar
  30. Nesbit RM, Baum WC (1950) Endocrine control of prostatic carcinoma. Clinical and statistical survey of 181 cases. JAMA 143: 1317CrossRefGoogle Scholar
  31. O’Connor VJ, Chiang SP, Grayhack JT (1963) Is subcapsular orchiectomy a difinitive procedure? Studies of hormone excretion before and after orchiectomy. J Urol 89: 236Google Scholar
  32. Oesterling JR, Epstein JI, Walsh PC (1986) Inability of adrenal androgens to stimulate adult human prostate. Autopsy Evaluation of men with hypogonadotropic hypogonadism and panhypopituitarism. J Urol 136: 1030PubMedGoogle Scholar
  33. Prout GR jr, Kliman B, Daly JJ, McLaughlin RA, Griffin PP, Young HH, II (1976) Endocrine changes after diethylstilbestrol therapy. Effects on prostatic neoplasm and pituitary-gonadal axis. Urology 7: 148PubMedCrossRefGoogle Scholar
  34. Redding TW, Schally AV (1985) Investigation of the combination of the agonist D-Trp-6-LHRH and the antiandrogen Flutamide in the treatment of Dunning R-3327-H prostatic cancer model. Prostate 6: 219PubMedCrossRefGoogle Scholar
  35. Robinson MRG, Thomas BS (1971) Effect of hormonal therapy on plasma testosterone levels in prostatic carcinoma. Br Med J 4: 391PubMedCrossRefGoogle Scholar
  36. Schröder FH, Kliju JG, de Jorg FA (1986) Metastatic cancer of the prostate managed by Buserelin acetate versus Buserelin acetate plus Cyproteron acetate. J Urol 135: 202AGoogle Scholar
  37. Schulze H, Isaacs JT (1986) Biology and therapy of prostatic cancer. Cancer Surv Vol 5, No 3Google Scholar
  38. Schulze H, Isaacs JT, Senge T (1987) Inability of complete androgen blockade to increase survival of patients with advanced prostate cancer as compared to standard hormonal therapy. J Urol (in press)Google Scholar
  39. Scott WW, Menon M, Walsh PC (1980) Hormonal therapy of prostatic cancer. Cancer 45: 1929PubMedGoogle Scholar
  40. Seidman H, Silverberg F, Bodden A (1978) Probabilities of eventually developing and dying of cancer (risk among persons previously undiagnosed with cancer). CA-Cancer J Clin 28: 33PubMedCrossRefGoogle Scholar
  41. Senge T, Hülshoff T, Tunn U, Schenk B, Neumann F (1978) Testosteronkonzentrationen im Serum nach subkapsulärer Orchiektomie. Urologe A 17: 382PubMedGoogle Scholar
  42. Shearer RJ, Hendry WF, Sommerville IF, Ferguson JD (1973) Plasma testosterone: An accurate monitor of hormone treatment in prostatic cancer. Br J Urol 45: 668PubMedCrossRefGoogle Scholar
  43. Silverberg F (1982) Cancer statistics. CA (New York) 32: 15Google Scholar
  44. Tomic R, Bergman B, Damber J-E (1983) Testicular endocrine function after wothdrawal of oestrogen treatment in patients with carcinoma of the prostate. Br. J Urol 55: 42PubMedCrossRefGoogle Scholar
  45. Tunn UW, Senge Th, Neumann F (1981) Serumkonzentrationen von Testosteron und Prolaktin nach operativer und medikamentöser Kastration — Eine Langzeitstudie bei Prostatakarzinom-Patienten. Verh Dtsch Ges Urol 32. Tagung ( 1980 ), Springer, Berlin Heidelberg New York, S 419–421Google Scholar
  46. Vest SA, Frazier TH (1946) Survival following castration for prostatic cancer. J Urol 56: 97PubMedGoogle Scholar
  47. Veterans Administration Cooperative Urological Research Group (VACURG) (1967) Treatment and survival of patients with cancer of the prostate. Surg Gynecol Obstet 124: 1011Google Scholar
  48. Walsh PC (1975) Physiologic basis for hormonal therapy in carcinoma of the prostate. Urol Clin North Am 2: 125PubMedGoogle Scholar
  49. Walsh PC, Siiteri PK (1975) Suppression of plasma androgens by spironolactone in castrated men with carcinoma of the prostate. J Urol 114: 254PubMedGoogle Scholar
  50. Young JL, Percey CL, Asire A J (1981) Surveillance, epidemiology and end results: incidence and mortality data, 1973–1977. Natl Cancer Inst Monogr 57, DHHS Publication No (NIH) 81, Washington, DCGoogle Scholar
  51. Young HH, II, Kent JR (1968) Plasma testosterone levels in patients with prostatic carcinoma before and after treatment. J Urol 99: 788PubMedGoogle Scholar
  52. Zadra J, Bruce AW, Trachtenberg J (1986) Total androgen ablation therapy in the treatment of advanced prostatic cancer. J Urol 135:201 AGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • H. Schulze
  • Th. Senge

There are no affiliations available

Personalised recommendations