Review
Hormonal treatment of prostate cancer [Tratamiento hormonal del cáncer de próstata]
Fecha
2004Autor
Cassinello, J.
Garcia Castro, I.
Arcediano, A.
Institución
Resumen
Nowadays, hormonal therapy has an essential role in the treatment of prostate carcinoma. Indications of hormonal therapy in different stages of prostate cancer are reviewed in this paper. We discuss the benefit of hormonotherapy as complementary treatment (adjuvant and neoadjuvant) associated with local therapy (surgery or radiotherapy) in localized and locally advanced disease. Some controversial items around first-line hormonal treatment are analyzed in relation to metastatic disease: combined androgen blockade versus LHRH analogs, immediate versus delayed androgen deprivation, intermittent versus continuous therapy. Also we evaluate alternative hormonal approaches as first-line treatment: antiandrogen monotherapy, finasteride, combined antiandrogen and finasteride therapy and triple androgen blockade. Finally we remark the usefulness of second-line hormonal therapy in advanced prostate cancer and we assess different treatment options: flutamide withdrawal syndrome, antiandrogens (bicalutamide, nilutamide, flutamide, megestrol acetate), adrenal inhibitors (ketoconazole, aminoglutethimide), corticosteroids and estrogens.