Abstract: Abiraterone acetate（AA），a new antiandrogen，has just recently been introduced into the Chinese market，and used once for most patients. We retrospectively analyzed the diagnosis and treatment process of two cases of metastatic prostate cancer（mPC）treated using a comprehensive treatment scheme including the “sandwich” therapy with AA，and found this scheme may be effective for mPC. Moreover，we also found that the response time of the first AA treatment may be longer if the first AA treatment was stopped as early as possible at the end of the hormone-sensitive period，but that may be shorter if being stopped later in the castrate-resistant period. Furthermore，early discontinuation of the first AA treatment significantly prolonged the overall drug response period and the cancer-specific survival. Therefore，the "sandwich" regimen of AA could be used as a new strategy to improve the efficacy of mPC. And the earlier discontinuation regimen will be more conducive to optimizing the existing sequential treatment of mPC than the later discontinuation regimen.

Key words: Prostatic neoplasms , Abiraterone acetate, Metastatic prostate cancer, Hormone sensitive prostate cancer, Castrate-resistant prostate cancer, Treatment outcome

摘要： 新型抗雄药物阿比特龙（AA）投入中国市场时间较短，多数患者只有单次用药经验。本文通过回顾分析转移性前列腺癌（mPC）患者的综合诊疗过程，观察两次重复服用AA的治疗价值，发现包含两次服用AA在内的“三明治”方案是有效的。并且，如首次AA治疗后能在激素敏感期的末期尽早停药，将使再次实施AA治疗的反应时间更长；相反，如已由激素敏感期进展为去势抵抗期内再停止首次AA治疗，将导致再次实施AA治疗的反应时间缩短。早期停用首次AA的“三明治”方案，总体药物治疗反应期及最终的肿瘤特异性生存期均显著延长。因此，AA的“三明治”方案可作为提高mPC疗效的新策略，并且首次AA的早期停药方案较晚期停药方案将更有利于延长mPC患者的总体药物治疗反应期及最终的肿瘤特异性生存期，从而实现对现有序贯治疗的进一步优化。

关键词: 前列腺肿瘤, 醋酸阿比特龙, 转移性前列腺癌, 激素敏感性前列腺癌, 去势抵抗性前列腺癌, 治疗结果