Tsukamoto S, Akaza H
Dept. of Urology, Hitachi General Hospital, Ibaraki, Japan.
Gan To Kagaku Ryoho. 1999 Feb;26(3):308-14.
We describe the progress in oral anti-cancer drug therapy for urological cancer. Pure antiandrogen (e.g., flutamide) is widely used as a means of maximal androgen blockade (MAB) in the treatment of prostate cancer. However, all series reported in the past several years did not show positive effects on prolongation of the patient's survival. Evaluations by meta-analysis are in progress. As the mechanism of antiandrogen withdrawal syndrome has been recognized, it was widely accepted that antiandrogen should be discontinued when disease progression or PSA elevation becomes evident. Estramustine was recently clarified as an effective therapeutic agent in the treatment of hormone refractory prostate cancer in combination with oral etoposide. Oral etoposide therapy has been tried as a maintenance or a palliative chemotherapy for non-curative or high-risk germ cell tumor. UFT (a compound of tegafur and uracil) is said to be effective for bladder cancer. It has been also suggested that UFT was partly effective as a means of first-line endocrine chemotherapy for advanced prostate cancer and was a promising agent in the treatment of advanced renal cell carcinoma in combination with Interferon-alpha. Usually the age of the patient with urological malignancy, excluding testicular cancer, is high and complicated. For such patients, an aggressive intravenous chemotherapy can not always be used. Therefore, a less aggressive, less toxic chemotherapy with oral drug is often planned to maintain QOL.
我们描述了泌尿系统癌症口服抗癌药物治疗的进展。单纯抗雄激素药物（如氟他胺）被广泛用作前列腺癌治疗中最大雄激素阻断（MAB）的一种手段。然而，过去几年报道的所有系列研究均未显示对延长患者生存期有积极作用。荟萃分析评估正在进行中。随着抗雄激素撤药综合征机制得到认识，人们普遍认为当疾病进展或前列腺特异性抗原（PSA）升高明显时应停用抗雄激素药物。雌莫司汀最近被明确为与口服依托泊苷联合用于治疗激素难治性前列腺癌的有效治疗药物。口服依托泊苷疗法已被尝试用于非治愈性或高危生殖细胞肿瘤的维持或姑息化疗。优福定（替加氟与尿嘧啶的复方制剂）据说对膀胱癌有效。也有人提出，优福定作为晚期前列腺癌一线内分泌化疗手段有部分疗效，并且与α干扰素联合使用时是治疗晚期肾细胞癌的一种有前景的药物。通常，除睾丸癌外，泌尿系统恶性肿瘤患者年龄较大且情况复杂。对于这类患者，并非总能采用积极的静脉化疗。因此，常计划采用侵袭性较小、毒性较低的口服药物化疗来维持生活质量。
