Glode L Michael, Barqawi Albaha, Crighton Frances, Crawford E David, Kerbel Robert
Oncology Urology Department, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
Cancer. 2003 Oct 15;98(8):1643-8. doi: 10.1002/cncr.11713.
The current study was designed to evaluate the efficacy and toxicity of the continuous oral administration of a combination of cyclophosphamide (50 mg/day given in the morning) and dexamethasone (1 mg/day given in the evening) in patients with prostate specific antigen (PSA) progression despite single or multiagent hormone therapy and antiandrogen withdrawal.
The authors retrospectively evaluated the medical records of all patients with prostate carcinoma who were treated with dexamethasone and cyclophosphamide and who were unable to participate in Phase II drug trials or had failed previous chemotherapy regimens.
Using clinical response guidelines set forth by the Prostate Specific Antigen Working Group, 29% of patients were found to have a > or = 80% reduction in PSA, 39% were found to have a 50-79% reduction in PSA, 6% were found to have a < 50% decrease in PSA, and 26% experienced disease progression while receiving treatment. The duration of response was 8 months (95% confidence interval [95% CI], 4-10 months). The duration of treatment was 9 months (95% CI, 6-14 months). The treatment was reported to be well tolerated with side effects being primarily bruising, Cushingoid facies, and gastrointestinal distress.
In the current study, low-dose dexamethasone and cyclophosphamide demonstrated efficacy as salvage therapy in the treatment of patients with hormone-refractory prostate carcinoma.
本研究旨在评估持续口服环磷酰胺（每日上午给药50毫克）与地塞米松（每日晚上给药1毫克）联合用药对尽管接受过单药或多药激素治疗及抗雄激素撤药但前列腺特异性抗原（PSA）仍进展的患者的疗效和毒性。
作者回顾性评估了所有接受地塞米松和环磷酰胺治疗、无法参加II期药物试验或既往化疗方案失败的前列腺癌患者的病历。
根据前列腺特异性抗原工作组制定的临床反应指南，发现29%的患者PSA降低≥80%，39%的患者PSA降低50 - 79%，6%的患者PSA降低<50%，26%的患者在接受治疗时疾病进展。反应持续时间为8个月（95%置信区间[95%CI]，4 - 10个月）。治疗持续时间为9个月（95%CI，6 - 14个月）。据报道，该治疗耐受性良好，副作用主要为瘀斑、库欣面容和胃肠道不适。
在本研究中，低剂量地塞米松和环磷酰胺作为挽救疗法在激素难治性前列腺癌患者的治疗中显示出疗效。
