抑那通治疗前列腺癌的新进展-课件

抑那通治疗前列腺癌的新进展抑那通治疗前列腺癌的新进展AUA(2019)内分泌治疗新进展Radiotherapycombinedwithandrogendeprivationvs.androgendeprivationaloneinclinicallylocallyadvancedprostatecanerinamulticenterrandomisedphaseIIIstudyNicolasMottet,France.AUA(2019)内分泌治疗新进展RadiotherapyAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESInlocallyadvanceddisease,thecombinationofradiotherapy(RT)andandrogendeprivation(ADT)issuperiortoRTalone.ButADTwithananaloguehasneverbeencomparedtocombinedmodality.WereportaphaseIIIrandomisedtrialinlocallyadvancedPCa,comparingacombinedmodalityandADTonly.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSInthisFrenchmulticenter,open,randomisedtrial,patientslessthan80years,withhistologicallyconfirmedPCa,T3-4,orpT3(biopsy)N0M0wereincluded.Theywerecentrallyrandomisedin2parallelgroupstoeitherADTalone(leuprorelin11.25mgSR,1scinjectionevery3monthsfor3yearsorthesameADTcombinedwithRTstartingwithin3monthsover7weeks.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSHTHT+RTPN131133MeanAge70.570.70.63MeanPSAbaseline51.7741.500.79MedianPFS(days)126425440.0005PFS(5year)(%)15.464.70.0005Biologicalprogression(%)71.519.5<0.0001Clinicalprogression(%)37.711.3<0.0001AUA(2019)内分泌治疗新进展RESULTSHTHT+RAUA(2019)内分泌治疗新进展Prevalenceofmetabolicsyndromeinprostatecancerpatientsunderandrogendeprivationtherapy:interimresultsofacase-controlstudy.JorgeRopero,Barcelone,Spain.AUA(2019)内分泌治疗新进展PrevalenceofAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESCardiovascularmortalityisthemostimportantcauseofdeathinpatientswithprostatecancer(PC).Thedevelopmentofmetabolicsyndrome(MS)inpatientsundergoingandrogendeprivationtherapy(ADT)hasbeenrelatedwiththisincreaseinmortalityrate.TheaimofthisstudyhasbeentoconfirmthehypothesisthatADTincreasestheprevalenceofMS.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSAgroupof157patientswereenrolledinthisinterimanalysisofaprospectivecasecontrolstudy.53PCpatientsunderADTduringameantimeof52months(6to252)and104agematchedcontrolsevaluatedatthetimeofprostatebiopsy(52withcancerand52without)wereincluded.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展METHODSMSwasanalyzedaccordingtheATPIIIpanelcriteria:Fastingplasmaglucoselevel>110mg/dLserumtriglyceridelevel>150mg/dLserumhigh-densitylipoproteinlevel<40mg/dLwaistcircumference>102cmBloodpressureof>130/85mmHg.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSMSwasdiagnosedin27ofthe53patientssubjectedtoADT(51.9%)whileitwasdetectedin35ofthe105age-matchedcontrols(33.3%),p=0.020.HowevertheprevalenceofMSwas35.8%(19/53)inmenwithoutPCand30.8%(16/52)inmenwithPC,p=0.365.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展CONCLUSIONAlthoughthelimitednumbercasesandcontrolsincludedinthisinterimanalysis,asignificantincreaseintheprevalenceofMSwasobservedinPCpatientssubjectedtoADT.AUA(2019)内分泌治疗新进展CONCLUSIONAUA(2019)内分泌治疗新进展MetabolicchangeafterandrogendeprivationtherapyinKoreanmenwithprostatecancerChangHooPark,KoreaAUA(2019)内分泌治疗新进展MetabolicchaAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESInmenwithprostatecancer,Androgendeprivationtherapyshowsavarietywellrecognizedmetabolicalteration.TobettercharacterizethemetaboliceffectsofandrogendeprivationtherapyinKoreanmen,weevaluatedthechangesinfatthickness,bonemineraldensity(BMD),bodymassindex(BMI),andlevelsofhemoglobin(Hb)andcholesterol.Wealsocomparedthemwithdatafromhealthysubjects.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSFromDecember2019toDecember2019,148Koreanmentreatedwithleuprolidedepotandbicalutamideforprostatecancerand100healthysubjectswereinvestigatedincludedchangefrombaselinetomonth12infatthickness,bonemineraldensity(BMD),bodymassindex(BMI),andlevelsofhemoglobin(Hb)andcholesterol.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSADTControlPN148100Fatthickness(mm)20.416.9<0.05BMD=bonemineraldensity0.910.94<0.05BMI(kg/m2)23.922.9<0.05Therearenosignificantchangesinhemoglobinandcholesterollevels.AUA(2019)内分泌治疗新进展RESULTSADTConAUA(2019)内分泌治疗新进展CONCLUSIONOurresultsshowthatKoreanmenwithprostatecancerhaveincreasedabdominalsubcutaneousfatandBMIandhavedecreasedBMDduringandrogendeprivationtherapy.Theseincreasestheriskofbonefractureandcomplicationrelatedobesity.Therefore,BMDwillbecheckedperiodicallyandcarryoutexerciseprogramtopreventionobesityduringandrogendeprivationtherapy.AUA(2019)内分泌治疗新进展CONCLUSIONAUA(2019)内分泌治疗新进展Sarcopeniainmenreceivingandrogendeprivationtherapyforprostatecancer:aprospective3-yearstudy.MatthewR.Smith,CA.AUA(2019)内分泌治疗新进展SarcopeniainAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESAndrogendeprivationtherapy(ADT)forprostatecancerdecreasesbonemineraldensityandincreasesfracturerisk.StudieswithlimitedsamplesizeandobservationalperiodshavereportedthatADTisalsoassociatedwithsarcopeniaorlossofmuscle(leanbodymass,LBM).WenowreporttheprospectivechangesinLBMinasubsetofmenfromthatstudy.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSMenundergoingADTfornonmetastaticprostatecancerat38centersinNorthAmericawererandomizedtodenosumaborplacebo.Atotalof248subjects(130denosumab,118placebo)withabaselineandwithatleast1on-studyLBMresultwereconsideredevaluableandincludedinthisanalysis.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展METHODSSubjectswerestratifiedatbaselinebyage(<70yearsvs≥70years)andbydurationofADTtreatment(≤6monthsvs>6months).LBMwasmeasuredbytotalbodydual-energyx-rayabsorptiometryatbaselineandat12,24,and36months.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSFrombaselinetomonth12,meanLBMdecreasedsignificantlyby1.0%(p=.0004).SignificantdecreasesinLBMwerealsoobservedatmonth24(2.1%,p<.0001)andmonth36(2.4%,p<.0001).AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSMenaged≥70years(n=127)hadsignificantlygreaterchangesinLBMatallmeasuredtimepoints.At36months,LBMdecreasedby2.8%inmenaged≥70yearscomparedwithadecreaseof0.9%inyoungermen(p=0.035).AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展CONCLUSIONThisisthelargestandlongestprospectivestudyundertakentodescribethenaturalhistoryofmusclelossinmenundergoingADTtherapyforprostatecancer.LBMsignificantlydecreasedat12,24,and36months.DecreasesinLBMweregreatestinoldermenandinthosewhohadshortdurationofADTatstudyentry.AUA(2019)内分泌治疗新进展CONCLUSIONAUA(2019)内分泌治疗新进展RecoveryoftestosteroneandPSAaftercessationoflongtermluteinizinghormonereleasinghormoneagonist(LHRH)therapyforprostatecancer:aprospectivetrial.MatthewMcIntyre,Charleston,SCAUA(2019)内分泌治疗新进展RecoveryoftAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESTheuseofhormonalmanipulationinthetreatmentofprostatecancerhasbeenanoptionsincethetimeofHugginsinitialdescription.However,manyquestionsremainregardingtimingofinitiation,andlengthoftreatmentintervalformedicallyinducedcastration.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESTheeffectsoflongtermLHRHagonistonthehypothymalicpituitarygonadalaxisarealsonotcompletelyunderstood.WesoughttoexaminetheeffectsoflongtermLHRHagonistonrecoveryoftestosteroneandPSA.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSHormonalablationwasdiscontinuedandserialtestosteroneandPSAmeasurementswereobtainedonathreemonthlybasis.Patientswerecounseledregardingrestartinghormonaltherapyif2consecutiverisesinPSAwereobserved.Patientswereallowedtostayoffhormonesandonstudyiftheydesired.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展METHODSWeorganizedaprospectivetrialexaminingmenattheVeteransAdministrationHospitalwhohadbeenonatleast48monthsofanLHRHagonist.OtherinclusioncriteriawerethatPSAbelessthan3ng/ml,andnotrisingforthe2consecutivevaluespriortodiscontinuinghormones.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSNineteenpatientswereenrolledinthestudybetween2019and2019.Themeanagewas75years.

Themeandurationofhormonaltherapywas88months.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSTen(53%)patientswereonhormonesforbiochemicalrecurrence；Two(10%)formetastaticdisease；Seven(36%)asprimarytherapy.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSEleven(58%)patientshad2consecutiverisesinPSA;Themeantimetoseetwoconsecutiveriseswas11months.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSThemeantimeofftherapypriortoariseinPSA0.1ng/mlabovebaselineforallpatientsandthosewith2consecutiveriseswas15.4and9.5monthsrespectively.ThemeanbaselinePSA,meanPSAatone,andattwoyearsofftherapywas0.3ng/ml,1.1ng/ml,and5ng/mlrespectively.Meantestosteroneatbaseline,one,andtwoyearsofftherapywas13.9ng/ml,76ng/ml,and150.6ng/mlrespectively.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSTwelve(63%)patientshadrecoveryoftestosteroneabove50ng/dl.Four(21%)patientsremainedcastrateofftherapyameanof20months.Themeantimetotestosteronerecoverywas12.8months.Two(10.5%)patientsinthestudyhavedied.Onedeathwasattributedtoprostatecancer.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展CONCLUSIONTherecoveryoftestosteroneandsignificantelevationsofPSAafterlongtermLHRHagonisttherapyissignificantlydelayedinmostpatients.Thishelpstosupporttheconceptofintermittentandrogenablationwhichhasbenefitsinqualityoflifeandreducedcostoftherapy.AUA(2019)内分泌治疗新进展CONCLUSIONDataonfile手术去势的副作用增加心血管疾病和糖尿病发病率Dataonfile手术去势的副作用Dataonfile手术去势的副作用增加骨折发病率Dataonfile手术去势的副作用抑那通通过抑制雄性激素的作用而抑制大白鼠前列腺肿瘤的增殖

醋酸亮丙瑞林水溶液0.333mg/kg/日（1日1次投药)醋酸亮丙瑞林水溶液0.333mg/kg/日（1日2次投药)抑那通相当于0.333mg/kg/日（1月1次投药)阉割肿瘤移植后的天数肿瘤体积(cm)对照醋酸亮丙瑞林水溶液1mg/kg/日（1日1次投药)抑那通与睾丸切除术抗肿瘤作用比较抑那通通过抑制雄性激素的作用而抑制大白鼠前列腺肿瘤的增殖抑那通治疗前列腺癌的综合效果抑那通治疗前列腺癌的综合效果抑那通治疗前列腺癌各病灶的疗效抑那通治疗前列腺癌各病灶的疗效抑那通改善前列腺癌各种症状的效果明显抑那通改善前列腺癌各种症状的效果明显抑那通治疗前列腺癌从起效到部分缓解的时间抑那通治疗前列腺癌从起效到部分缓解的时间

间歇疗法与持续疗法患者生存率相当Dataonfile间歇疗法与持续疗法患者生存率相当Dataonfile抑那通间歇疗法显著降低前列腺体积第1周期第2周期前列腺体积变化比例(%)BruchovskyN,etal.Cancer.2019Jul15;107(2):389-95抑那通间歇疗法显著降低前列腺体积第1周期第2周期前列腺体积变抑那通间歇疗法迅速降低PSA值到达PSA最低值所需时间(月)HiganoCS,etal.Urology.2019Nov;48(5):800-4抑那通间歇疗法迅速降低PSA值到达PSA最低值所需时间(月)间歇疗法减少骨质丢失，降低副反应发生率UifTunn2019BjuInternational99,supplement1,19-22间歇疗法减少骨质丢失，降低副反应发生率UifTunn20Dataonfile间歇期雄激素明显恢复，可改善患者生活质量Dataonfile间歇期雄激素明显恢复，可改善患者生活间歇疗法有利于患者性功能恢复N.A.Spry,etalEuropeanJournalofCancer42(2019):1083-1092间歇疗法有利于患者性功能恢复N.A.Spry,etalE间歇期暂停用药，大幅度降低治疗成本间歇期暂停用药，大幅度降低治疗成本总结

有效治疗前列腺癌患者生存率与持续疗法相当与去势疗法相比，副作用显著降低改善性功能，提高生活质量降低治疗成本抑那通间歇疗法优势突出总结有效治疗前列腺癌抑那通间歇疗法优势突出抑那通3.75mg预充式注射器现有剂型上市新剂型抑那通3.75mg预充式注射器现有剂型上市新剂型抑那通治疗前列腺癌的新进展抑那通治疗前列腺癌的新进展AUA(2019)内分泌治疗新进展Radiotherapycombinedwithandrogendeprivationvs.androgendeprivationaloneinclinicallylocallyadvancedprostatecanerinamulticenterrandomisedphaseIIIstudyNicolasMottet,France.AUA(2019)内分泌治疗新进展RadiotherapyAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESInlocallyadvanceddisease,thecombinationofradiotherapy(RT)andandrogendeprivation(ADT)issuperiortoRTalone.ButADTwithananaloguehasneverbeencomparedtocombinedmodality.WereportaphaseIIIrandomisedtrialinlocallyadvancedPCa,comparingacombinedmodalityandADTonly.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSInthisFrenchmulticenter,open,randomisedtrial,patientslessthan80years,withhistologicallyconfirmedPCa,T3-4,orpT3(biopsy)N0M0wereincluded.Theywerecentrallyrandomisedin2parallelgroupstoeitherADTalone(leuprorelin11.25mgSR,1scinjectionevery3monthsfor3yearsorthesameADTcombinedwithRTstartingwithin3monthsover7weeks.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSHTHT+RTPN131133MeanAge70.570.70.63MeanPSAbaseline51.7741.500.79MedianPFS(days)126425440.0005PFS(5year)(%)15.464.70.0005Biologicalprogression(%)71.519.5<0.0001Clinicalprogression(%)37.711.3<0.0001AUA(2019)内分泌治疗新进展RESULTSHTHT+RAUA(2019)内分泌治疗新进展Prevalenceofmetabolicsyndromeinprostatecancerpatientsunderandrogendeprivationtherapy:interimresultsofacase-controlstudy.JorgeRopero,Barcelone,Spain.AUA(2019)内分泌治疗新进展PrevalenceofAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESCardiovascularmortalityisthemostimportantcauseofdeathinpatientswithprostatecancer(PC).Thedevelopmentofmetabolicsyndrome(MS)inpatientsundergoingandrogendeprivationtherapy(ADT)hasbeenrelatedwiththisincreaseinmortalityrate.TheaimofthisstudyhasbeentoconfirmthehypothesisthatADTincreasestheprevalenceofMS.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSAgroupof157patientswereenrolledinthisinterimanalysisofaprospectivecasecontrolstudy.53PCpatientsunderADTduringameantimeof52months(6to252)and104agematchedcontrolsevaluatedatthetimeofprostatebiopsy(52withcancerand52without)wereincluded.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展METHODSMSwasanalyzedaccordingtheATPIIIpanelcriteria:Fastingplasmaglucoselevel>110mg/dLserumtriglyceridelevel>150mg/dLserumhigh-densitylipoproteinlevel<40mg/dLwaistcircumference>102cmBloodpressureof>130/85mmHg.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSMSwasdiagnosedin27ofthe53patientssubjectedtoADT(51.9%)whileitwasdetectedin35ofthe105age-matchedcontrols(33.3%),p=0.020.HowevertheprevalenceofMSwas35.8%(19/53)inmenwithoutPCand30.8%(16/52)inmenwithPC,p=0.365.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展CONCLUSIONAlthoughthelimitednumbercasesandcontrolsincludedinthisinterimanalysis,asignificantincreaseintheprevalenceofMSwasobservedinPCpatientssubjectedtoADT.AUA(2019)内分泌治疗新进展CONCLUSIONAUA(2019)内分泌治疗新进展MetabolicchangeafterandrogendeprivationtherapyinKoreanmenwithprostatecancerChangHooPark,KoreaAUA(2019)内分泌治疗新进展MetabolicchaAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESInmenwithprostatecancer,Androgendeprivationtherapyshowsavarietywellrecognizedmetabolicalteration.TobettercharacterizethemetaboliceffectsofandrogendeprivationtherapyinKoreanmen,weevaluatedthechangesinfatthickness,bonemineraldensity(BMD),bodymassindex(BMI),andlevelsofhemoglobin(Hb)andcholesterol.Wealsocomparedthemwithdatafromhealthysubjects.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSFromDecember2019toDecember2019,148Koreanmentreatedwithleuprolidedepotandbicalutamideforprostatecancerand100healthysubjectswereinvestigatedincludedchangefrombaselinetomonth12infatthickness,bonemineraldensity(BMD),bodymassindex(BMI),andlevelsofhemoglobin(Hb)andcholesterol.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSADTControlPN148100Fatthickness(mm)20.416.9<0.05BMD=bonemineraldensity0.910.94<0.05BMI(kg/m2)23.922.9<0.05Therearenosignificantchangesinhemoglobinandcholesterollevels.AUA(2019)内分泌治疗新进展RESULTSADTConAUA(2019)内分泌治疗新进展CONCLUSIONOurresultsshowthatKoreanmenwithprostatecancerhaveincreasedabdominalsubcutaneousfatandBMIandhavedecreasedBMDduringandrogendeprivationtherapy.Theseincreasestheriskofbonefractureandcomplicationrelatedobesity.Therefore,BMDwillbecheckedperiodicallyandcarryoutexerciseprogramtopreventionobesityduringandrogendeprivationtherapy.AUA(2019)内分泌治疗新进展CONCLUSIONAUA(2019)内分泌治疗新进展Sarcopeniainmenreceivingandrogendeprivationtherapyforprostatecancer:aprospective3-yearstudy.MatthewR.Smith,CA.AUA(2019)内分泌治疗新进展SarcopeniainAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESAndrogendeprivationtherapy(ADT)forprostatecancerdecreasesbonemineraldensityandincreasesfracturerisk.StudieswithlimitedsamplesizeandobservationalperiodshavereportedthatADTisalsoassociatedwithsarcopeniaorlossofmuscle(leanbodymass,LBM).WenowreporttheprospectivechangesinLBMinasubsetofmenfromthatstudy.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSMenundergoingADTfornonmetastaticprostatecancerat38centersinNorthAmericawererandomizedtodenosumaborplacebo.Atotalof248subjects(130denosumab,118placebo)withabaselineandwithatleast1on-studyLBMresultwereconsideredevaluableandincludedinthisanalysis.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展METHODSSubjectswerestratifiedatbaselinebyage(<70yearsvs≥70years)andbydurationofADTtreatment(≤6monthsvs>6months).LBMwasmeasuredbytotalbodydual-energyx-rayabsorptiometryatbaselineandat12,24,and36months.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSFrombaselinetomonth12,meanLBMdecreasedsignificantlyby1.0%(p=.0004).SignificantdecreasesinLBMwerealsoobservedatmonth24(2.1%,p<.0001)andmonth36(2.4%,p<.0001).AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSMenaged≥70years(n=127)hadsignificantlygreaterchangesinLBMatallmeasuredtimepoints.At36months,LBMdecreasedby2.8%inmenaged≥70yearscomparedwithadecreaseof0.9%inyoungermen(p=0.035).AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展CONCLUSIONThisisthelargestandlongestprospectivestudyundertakentodescribethenaturalhistoryofmusclelossinmenundergoingADTtherapyforprostatecancer.LBMsignificantlydecreasedat12,24,and36months.DecreasesinLBMweregreatestinoldermenandinthosewhohadshortdurationofADTatstudyentry.AUA(2019)内分泌治疗新进展CONCLUSIONAUA(2019)内分泌治疗新进展RecoveryoftestosteroneandPSAaftercessationoflongtermluteinizinghormonereleasinghormoneagonist(LHRH)therapyforprostatecancer:aprospectivetrial.MatthewMcIntyre,Charleston,SCAUA(2019)内分泌治疗新进展RecoveryoftAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESTheuseofhormonalmanipulationinthetreatmentofprostatecancerhasbeenanoptionsincethetimeofHugginsinitialdescription.However,manyquestionsremainregardingtimingofinitiation,andlengthoftreatmentintervalformedicallyinducedcastration.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展INTRODUCTIONANDOBJECTIVESTheeffectsoflongtermLHRHagonistonthehypothymalicpituitarygonadalaxisarealsonotcompletelyunderstood.WesoughttoexaminetheeffectsoflongtermLHRHagonistonrecoveryoftestosteroneandPSA.AUA(2019)内分泌治疗新进展INTRODUCTIONAUA(2019)内分泌治疗新进展METHODSHormonalablationwasdiscontinuedandserialtestosteroneandPSAmeasurementswereobtainedonathreemonthlybasis.Patientswerecounseledregardingrestartinghormonaltherapyif2consecutiverisesinPSAwereobserved.Patientswereallowedtostayoffhormonesandonstudyiftheydesired.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展METHODSWeorganizedaprospectivetrialexaminingmenattheVeteransAdministrationHospitalwhohadbeenonatleast48monthsofanLHRHagonist.OtherinclusioncriteriawerethatPSAbelessthan3ng/ml,andnotrisingforthe2consecutivevaluespriortodiscontinuinghormones.AUA(2019)内分泌治疗新进展METHODSAUA(2019)内分泌治疗新进展RESULTSNineteenpatientswereenrolledinthestudybetween2019and2019.Themeanagewas75years.

Themeandurationofhormonaltherapywas88months.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSTen(53%)patientswereonhormonesforbiochemicalrecurrence；Two(10%)formetastaticdisease；Seven(36%)asprimarytherapy.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSEleven(58%)patientshad2consecutiverisesinPSA;Themeantimetoseetwoconsecutiveriseswas11months.AUA(2019)内分泌治疗新进展RESULTSAUA(2019)内分泌治疗新进展RESULTSThemeantimeofftherapypriortoariseinPSA0.1ng/mlabovebaselineforallpatientsandthosewith2consecutiveriseswas15.4and9.5