Joerger M, Oehlschlegel C, Cerny T, Gillessen S
Departement of Medical Oncology, Kantonsspital St. Gallen, Switzerland.
Onkologie. 2002 Dec;25(6):558-61. doi: 10.1159/000068628.
Prostatic postradiation sarcoma (PRS) is a very rare malignant disease with a dismal prognosis. Aggressive surgical resection is the most widely used therapy for PRS. Chemotherapy so far has been unsatisfactory, with doxorubicin being the only drug with established activity. Liposomal doxorubicin has been shown to have comparable activity and a more favorable toxicity profile compared with unpegylated doxorubicin.
A 78-year-old man presented with high-grade myofibroblastic sarcoma 13 years after curatively intended pion irradiation of the prostate with 30 Gy. He was treated with liposomal doxorubicin 40 mg/m(2) every 4-6 weeks up to now with a total dose of 800 mg. Partial remission has been achieved after 17 months of treatment with liposomal doxorubicin. Toxicity is minimal with palmoplantar erythrodysesthesia WHO grade 1, resolving completely after extending treatment intervals to 6 weeks.
Liposomal doxorubicin led to a sustained tumor stabilization over 17 months in a patient with prostatic postradiation high-grade sarcoma. Postradiation sarcoma (PRS) usually has a dismal prognosis and only very limited therapeutic possibilities. As in sarcomas of different origin, anthracyclines including liposomal doxorubicin seem to have potential antitumor activity in postradiation sarcoma of the prostate.
前列腺放疗后肉瘤（PRS）是一种非常罕见的恶性疾病，预后很差。积极的手术切除是治疗PRS最广泛使用的方法。到目前为止，化疗效果并不理想，阿霉素是唯一具有确定活性的药物。与未聚乙二醇化的阿霉素相比，脂质体阿霉素已显示出具有相当的活性和更有利的毒性特征。
一名78岁男性在前列腺接受30 Gy的根治性π介子照射13年后出现高级别肌成纤维细胞肉瘤。他目前每4 - 6周接受40 mg/m²的脂质体阿霉素治疗，总剂量达800 mg。接受脂质体阿霉素治疗17个月后已实现部分缓解。毒性最小，掌跖红细胞感觉异常为WHO 1级，将治疗间隔延长至6周后完全缓解。
脂质体阿霉素使一名前列腺放疗后高级别肉瘤患者的肿瘤持续稳定了17个月。放疗后肉瘤（PRS）通常预后很差，治疗可能性非常有限。与不同起源的肉瘤一样，包括脂质体阿霉素在内的蒽环类药物似乎在前列腺放疗后肉瘤中具有潜在的抗肿瘤活性。
