Your browser does not support the NLM PubReader view.

Go to this page to see a list of supporting browsers.

Current Concepts in Androgen Deprivation Therapy

Article information

J Korean Med Assoc. 2004;47(5):408-416
Publication date (electronic) : 2004 May 31
doi : https://doi.org/10.5124/jkma.2004.47.5.408
Jeong Hee Hong, M.D., Han Yong Choi, M.D.
Department of Urology, Sungkyunkwan University School of Medicine, Samsung Seoul Medical Center, Korea. hjh178@freechal.com, hychoi@smc.samsung.co.kr

Abstract

The hormonal sensitivity of prostate cancer has been exploited clinically since Huggins and Hodges established the suppressive effects of castration on prostate cancer. Despite over sixty years of research into alternate modalities, androgen deprivation therapy (ADT) has become the mainstay treatment for locally advanced and metastatic prostate cancer. Suppression of testosterone production, the primary goal of hormonal therapy, can be achieved by a multitude of treatments. The ideal timing, duration and composition of ADT remains undefined. At the present time, first-line therapy consists of orchiectomy, luteinizing hormone-releasing hormone (LHRH) analogues or complete androgen blockade (CAB). However, new combinations and treatment settings show promise for improving outcomes and decreasing toxicity. This article provides an overview of the hormonal therapies currently used in advanced prostate cancer.

Keywords: Prostate cancer; Castration; Androgen antagonists

References

1. Gheiler EL, Tiguert R. Current concepts in androgen deprivation therapy-is there a "best" endocrine treatment? World J Urol 2000. 18190–193.
2. Mcleod DG. Hormonal therapy:historical perspective to future directions. Urology 2003. 61Suppl. 3–7.
3. Higano CS. Side effects of androgen deprivation therapy: monitoring and minimizing toxicity. Urology 2003. 61Suppl. 32–38.
4. Laufer M, Denmeade SR, Sinibaldi VJ, Carducci MA, Eisenberger MA. Complete androgen blockade for prostate cancer: what went wrong? J Urol 2000. 1643–9.
5. OH WK. Secondary hormonal therapies in the treatment of prostate cancer. Urology 2002. 60Suppl. 87–93.
6. Sessions AE, Messing EM. Timing hormonal therapy in prostate cancer. Urol Clin North Am 2002. 29223–227.
7. Hellerstedt BA, Pienta KJ. The truth is out there: an overall perspective on androgen deprivation. Urol Oncol 2003. 21272–281.

Article information Continued

Copyright © 2004 Korean Medical Association

Figure 1

Figure 1

LHRH : luteinising hormone-releasing hormone, LH : luteinising hormone, FSH : follicle-stimulating hormone, ACTH : adrenocorticotrophic hormone, DHT : dihydrotestosterone

Table 1

Table 1

ADT : androgen deprivation therapy, OS : overall survival, PFS : progression-free survival, DFS : disease-free survival, XRT : radiation therapy

Table 2

Table 2

* The trial of de Voogt et al with a 3-arm design is counted in 2 categories