Zusammenfassung
Beim fortgeschrittenen Prostatakarzinom ist seit den grundlegenden Arbeiten von Huggins u. Hodges (1941) die endokrine Behandlung die Therapie der Wahl. Die Prinzipien dieser Therapie haben sich in den letzten 50 Jahren nicht wesentlich verändert, sie beruhen auf der Senkung des Testosterons. Dieser Testosteronabfall wird erreicht durch Orchiektomie, gegengeschlechtliche Hormone oder neuerdings durch die Applikation von LH-RH Analoga, mit denen eine chemische Kastration erzielt wird. Die Testosteronwerte fallen mit allen 3 Maßnahmen auf etwa 1/10 des Ausgangswertes (Tabelle 1). Die Bedeutung dieser Restandrogene, die überwiegend aus der Nebennierenrinde stammen, ist zum gegenwärtigen Zeitpunkt durch den Versuch einer „kompletten Androgenblockade“ beim fortgeschrittenen Prostatakarzinom wieder aktuell geworden, eine endgültige Beurteilung steht jedoch noch aus.
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Becker, H. et al. (1991). Therapeutische Kontroverse. In: Ackermann, R., Altwein, J.E., Faul, P. (eds) Aktuelle Therapie des Prostatakarzinoms. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84264-1_17
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