Although extremely efficient in achieving complete medical
castration and well tolerated, with no other side effects
than the expected hypoandrogenicity, GnRH agonists should
not be administered alone. In fact, shortly after discovery of
the castration effects of GnRH agonists, we observed that
approximately 50% of androgens remain in the prostate after
castration, thus leading to the recognition of the role of adrenal
dehydroepiandrosterone as an important source of the
androgens synthesized locally in the prostate and in many
peripheral target tissues. We therefore developed combined
androgen blockade (CAB), whereby the androgens of both
testicular and adrenal origins are blocked simultaneously at
start of treatment with the combination of a GnRH agonist to
block the testis and a pure antiandrogen to block the action
of the androgens produced locally. CAB, first used in advanced
metastatic disease, has been the first treatment shown
to prolong life in prostate cancer. Most interestingly, in 2002,
we made the observation that CAB alone given continuously
for 6.5 yr or more leads to cure of the disease in at least 90%
of cases, thus suggesting that androgen blockade combining
a GnRH agonist and a pure antiandrogen could well be the
most efficient treatment of localized prostate cancer, and thus
offering the possibility of practically eliminating death from
prostate cancer.
不要用GOOGLE在线翻译~我不是傻子~期待真正高手！