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1、SecondaryhormonalmanipulationincastrationresistantprostatecancerSohaibAl-Asaaed,MD,EricWinquist,MDLondonHealthSciencesCentreandWesternUniversity,London,Ontario,CanadaAL-ASAAEDS,WINQUISTE.Secondaryhormonaldiscussedwithpatientsandtheirpreferencesconsidered.manipulationincastrationres
2、istantprostatecancer.Inmenwithoutclinicalevidenceofmetastases,gonadalCanJUrol2014;21(Suppl1):37-41.androgensuppressionshouldbemaintainedandgenerallypatientsshouldbeobserved.ThereisnoclearevidenceIntroduction:CastrationresistantprostatecancerthatSHMsareofbenefitinthesepatients.Abira
3、terone(CRPC)isthesinglecommonpathwaytoprostateplusprednisoneisofprovenbenefitinmenwithCRPCcancerdeath.Formenwithsymptomaticmetastaticmetastaseswhoarewithoutsignificantsymptomspriordisease,docetaxelchemotherapyremainsastandardoftochemotherapy.Basedonemergingdata,enzalutamidecare.How
4、ever,bloodprostatic-specificantigen(PSA)maybeofsimilarbenefit.UseofotherSHMsshouldtestingallowstheidentificationofCRPCbeforeclinicalbebasedonpatientpreferenceandconsiderationofmetastasesorsymptomsoccur,providingalongdiagnosticpossibleadverseeffects;withtheexceptionoflowdoseleadtime
5、inmanypatients.Theuseofsecondaryprednisone,thereislittleevidenceofbenefitsupportinghormonalmanipulations(SHMs)inmennotcandidatestheiruse.Forpatientsacceptingtheseuncertainties,aforimmediatechemotherapyisreviewed.trialofnonsteroidalantiandrogenmaybeconsideredasanMaterialsandmethods:
6、PubMedwassearchedforadjuncttoobservation,followedbylowdosecorticosteroidrandomizedclinicaltrials,systematicreviewsorclinicalwithimmediateordelayedadditionofabiraterone(inmenpracticeguidelinesaddressingSHMsinCRPC.withmetastases)asareasonablenextstep.Results:Arecentsystematicreviewan
7、dpracticeguidelinewasidentified,andusedastheevidencebaseforthisreviewKeyWords:enzalutamide,hormone-dependent,alongwithreportsfromrandomizedtrialsoverthepastyear.prostaticneoplasms,castrationresistant,abiraterone,Conclusions:ThegoalsoftherapywithSHMsshouldbedrugtherapyIntroductionTh
8、ereisnocleartemporalrelati
