前立腺がんの内分泌療法

Endocrine therapy for prostate cancer.

　前立腺がんに対する内分泌療法はアンドロゲン除去療法と抗アンドロゲン薬であり，進行性前立腺がんの標準治療である。大部分の前立腺がんにおいて内分泌療法は効果を認めるが，治療継続に伴い内分泌療法に治療抵抗性を示すようになり，去勢抵抗性前立腺がんとなる。本稿では，前立腺がんに対する内分泌療法の種類，内分泌療法の生理学的な作用機序，本邦や欧米での実臨床での使用方法，去勢抵抗性前立腺がんに対する新たな内分泌療法，そして内分泌療法において注意すべき副作用に関して概説する。

　Endocrine therapy for prostate cancer is androgen deprivation therapy and antiandrogens, which are the standard treatment for advanced prostate cancer. Endocrine therapy is effective in most prostate cancers, but as treatment continues, most patients eventually experience resistant to endocrine therapy and disease progression. Patients in this state are said to have castration-resistant prostate cancer. This review outlines the types of endocrine therapy for prostate cancer, the physiological mechanisms of endocrine therapy, its clinical use in Japan and the United States and Europe, new endocrine therapy for castration-resistant prostate cancer, and the side effects to be noted in endocrine therapy.