Itoh Naoki
Department of Urology, Sapporo Medical University School of Medicine.
Nihon Rinsho. 2005 Feb;63(2):293-7.
The clinical significance of chemotherapy for patients with hormone refractory prostate cancer(HRPC) is still controversial. Some randomized-controlled trials represented that mitoxantrone combined with prednisone (or hydrocortisone) provided palliative benefit to patients with HRPC. These treatments are well tolerated by elderly patients. On the other hand, the high PSA response rates have been observed in trials with both estramustine and taxane, however, higher toxicity was also recognized. The most relevant endpoint is not only palliative efficacy but also survival in these trials. Recently, the improvement of survival with docetaxel-based chemotherapy was reported. Further studies with chemotherapeutic agents will be needed to provide patients of HRPC good quality of life and longer survival.
化疗对于激素难治性前列腺癌(HRPC)患者的临床意义仍存在争议。一些随机对照试验表明,米托蒽醌联合泼尼松(或氢化可的松)可为HRPC患者带来姑息性益处。老年患者对这些治疗的耐受性良好。另一方面,在雌莫司汀和紫杉烷的试验中均观察到了较高的前列腺特异性抗原(PSA)反应率,然而,也认识到了更高的毒性。在这些试验中,最相关的终点不仅是姑息疗效,还包括生存率。最近,有报道称基于多西他赛的化疗可提高生存率。需要进一步开展化疗药物研究,以提高HRPC患者的生活质量并延长生存期。