Vordos Dimitri, Paule Bernard, Vacherot Francis, Allory Yves, Salomon Laurent, Hoznek Andras, Yiou René, Chopin Dominique, Abbou Claude Clément, de la Taille Alexandre
Department of Urology, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France.
BJU Int. 2004 Sep;94(4):524-7. doi: 10.1111/j.1464-4096.2004.04919.x.
To evaluate the safety and efficacy of combined docetaxel-zoledronic acid treatment in patients with metastatic hormone-refractory prostate cancer (HRPC), as bisphosphonates are reported have a synergistic antitumoral effect when combined with taxanes.
Between January 2001 and June 2003, 14 patients with HRPC were treated; their mean (range) age was 71 (57-86) years and mean prostate-specific antigen (PSA) level 202 (6-489) ng/mL. Five patients had had previous chemotherapy (cyclophosphamide in two, mitoxantrone-prednisolone in three). The response criteria were the Karnofsky performance status, a positive response in mean daily analgesic consumption (defined as a decrease by more than half), decreased serum PSA (by more than half) at 8 weeks, blood transfusion, bone scan at 6 months, skeletal-related events and survival.
Patients received a mean (range) of 7.3 (6-10) cycles of therapy; there was no reported drug-related toxicity and all patients stayed at home for their treatment. Only three patients required a blood transfusion and no bone fractures were reported. At 2 months, six patients requiring analgesic drugs decreased their consumption by more than half (anti-inflammatory, paracetamol, narcotics) and eight had a reduction in PSA by more than half; of these eight with a PSA response at 2 months, six had biochemical progression with a mean delay of 6.2 (3-11) months. At 6 months, five patients had disease progression on bone scan. Nine patients had chemo-naïve hormone-refractory prostate cancer; three had biochemical progression at 2 months and two of these had progression on their bone scan. Two patients died at 7 and 15 months of follow-up; the mean follow-up was 10.2 (6-15) months. Using Kaplan-Meier plots, biochemical progression-free survivals were five of 14 at 6 months and two of 14 at 12 months; overall survival was 12 of 14 at 6 and 12 months.
Docetaxel-zoledronic acid therapy is safe and decreased the serum PSA by more than half at 2 months in more than half the patients. Prospective randomized trials are needed to assess this new approach.
鉴于有报道称双膦酸盐与紫杉烷类联合使用时具有协同抗肿瘤作用，评估多西他赛 - 唑来膦酸联合治疗转移性激素难治性前列腺癌（HRPC）患者的安全性和疗效。
2001年1月至2003年6月期间，对14例HRPC患者进行了治疗；他们的平均（范围）年龄为71（57 - 86）岁，平均前列腺特异性抗原（PSA）水平为202（6 - 489）ng/mL。5例患者曾接受过化疗（2例使用环磷酰胺，3例使用米托蒽醌 - 泼尼松龙）。疗效评估标准包括卡氏功能状态评分、平均每日镇痛药消耗量呈阳性反应（定义为减少超过一半）、8周时血清PSA降低（超过一半）、输血情况、6个月时的骨扫描、骨相关事件和生存率。
患者平均（范围）接受了7.3（6 - 10）个周期的治疗；未报告与药物相关的毒性反应，所有患者均在家中接受治疗。仅3例患者需要输血，未报告骨折情况。2个月时，6例需要镇痛药的患者其消耗量减少了一半以上（抗炎药、对乙酰氨基酚、麻醉药），8例患者的PSA降低了一半以上；在这8例2个月时PSA有反应的患者中，6例出现生化进展，平均延迟时间为6.2（3 - 11）个月。6个月时，5例患者骨扫描显示疾病进展。9例患者为初治激素难治性前列腺癌；3例在2个月时出现生化进展，其中2例骨扫描显示进展。2例患者在随访7个月和15个月时死亡；平均随访时间为10.2（6 - 15）个月。使用Kaplan - Meier曲线分析，6个月时14例患者中有5例无生化进展存活，12个月时14例中有2例；6个月和12个月时总生存率为14例中的12例。
多西他赛 - 唑来膦酸治疗是安全的，超过一半的患者在2个月时血清PSA降低超过一半。需要进行前瞻性随机试验来评估这种新方法。
Zotero 插件