Miyake Hideaki, Hara Isao, Yamazaki Hiroshi, Eto Hiroshi
Department of Urology, Hyogo Medical Center for Adults, 13-70 Kitaohji-cho, Akashi 673-8558, Japan.
Oncol Rep. 2005 Sep;14(3):673-6.
There is no standard therapeutic strategy for advanced hormone refractory prostate cancer after the initial hormonal therapy fails. The objective of this study was to retrospectively evaluate the clinical outcome of the oral anticancer agent, uracil/tegafur (UFT) for patients with hormone refractory prostate cancer. This study included 68 patients with hormone refractory prostate cancer treated by oral administration of UFT (300-600 mg/day). All patients had previously received maximum androgen blockade (MAB) which failed. In this series, response was defined as more than 50% decrease from the baseline prostate specific antigen (PSA) value at the start of second line therapy. Upon initiating administration of UFT, a reduction in PSA value was observed in 41 of the 68 patients (60.3%), among whom 13 (19.1%) were regarded as responders; however, PSA value continued to increase in the remaining 27 (39.7%). Median duration of PSA response was 7 months (range 1-22 months). During the observation period, there were no severe side effects due to UFT administration, but 7 patients transiently presented appetite loss. Patients without bone metastasis at the initial diagnosis or whose serum PSA value at the start of UFT therapy was less than 2.0 ng/ml showed a significantly higher incidence of PSA response to UFT; however, other factors examined had no significant impact on PSA response to UFT. Furthermore, cause-specific survival in responders to UFT therapy was significantly better than that in non-responders. These findings suggest that administration of UFT after the failure of initial MAB therapy can achieve a comparatively favorable PSA response without severe side effects; therefore, it may be worthy to consider administering UFT to patients with hormone refractory prostate cancer.
对于初始激素治疗失败后的晚期激素难治性前列腺癌，目前尚无标准的治疗策略。本研究的目的是回顾性评估口服抗癌药物替加氟尿嘧啶（UFT）治疗激素难治性前列腺癌患者的临床疗效。本研究纳入了68例接受UFT口服治疗（300 - 600mg/天）的激素难治性前列腺癌患者。所有患者此前均接受过最大雄激素阻断（MAB）治疗，但均失败。在本系列研究中，反应被定义为二线治疗开始时前列腺特异性抗原（PSA）值较基线值下降超过50%。开始给予UFT后，68例患者中有41例（60.3%）观察到PSA值下降，其中13例（19.1%）被视为有反应者；然而，其余27例（39.7%）患者的PSA值持续升高。PSA反应的中位持续时间为7个月（范围1 - 22个月）。在观察期内，未出现因UFT给药导致的严重副作用，但有7例患者出现短暂食欲减退。初始诊断时无骨转移或UFT治疗开始时血清PSA值小于2.0 ng/ml的患者对UFT的PSA反应发生率显著更高；然而，所检查的其他因素对UFT的PSA反应无显著影响。此外，UFT治疗有反应者的特定病因生存率显著优于无反应者。这些发现表明，初始MAB治疗失败后给予UFT可获得相对良好的PSA反应且无严重副作用；因此，对于激素难治性前列腺癌患者，考虑给予UFT治疗可能是值得的。
