Matsumoto Akihiro, Inoue Atsushi, Yokoi Satoshi, Nozumi Kazuyoshi, Miyazaki Kanetaka, Hosoki Shigeru, Nagata Maki, Yamaguchi Kunio
Department of Urology, Yokohama Rosai Hospital, Kouhoku-ku,Yokohama-shi, Kanagawa, Japan.
Int J Urol. 2009 Aug;16(8):687-91. doi: 10.1111/j.1442-2042.2009.02341.x. Epub 2009 Jul 8.
To investigate the feasibility and efficacy of docetaxel-based chemotherapy in patients with hormone-refractory prostate cancer (HRPC).
Forty-six consecutive HRPC patients treated between January 2003 and March 2008 were included in this analysis. Docetaxel was given at a dose of 35 mg/m(2) twice every 3 weeks and oral estramustine concurrently for three consecutive days during weeks 1 and 2 of each cycle. During each treatment week, the dose of estramustine was 1260 mg on the first day, 980 mg on the second day and 840 mg on the third day. Patients were premedicated with 4 mg twice a day of oral dexamethasone for three consecutive days. Treatment was continued until evidence of disease progression or unacceptable toxicity. Prostate-specific antigen (PSA) levels were evaluated at least once every 4 weeks.
Patients received a median of three cycles of chemotherapy. Of the evaluable 46 patients, 25 (54%) had a >or=50% PSA decline and 12 (26%) had a >or=75% PSA decline. Median time to PSA progression and overall survival time were 10.1 and 27.0 months, respectively. Median follow-up was 15.0 months. Major severe toxicities were grade 3 or 4 leukopenia in five (11%) patients. Mild toxicities included grade 1 or 2 nausea in eight (17%) patients. Two patients could not continue the treatment because of interstitial pneumonitis and a gastric hemorrhage, respectively.
Docetaxel plus estramustine chemotherapy represents an active and well tolerated treatment for Japanese HRPC patients.
探讨多西他赛为主的化疗方案用于激素难治性前列腺癌（HRPC）患者的可行性及疗效。
纳入2003年1月至2008年3月间连续治疗的46例HRPC患者。多西他赛剂量为35mg/m²，每3周给药2次，在每个周期的第1周和第2周连续3天同时口服雌莫司汀。每个治疗周中，雌莫司汀第1天剂量为1260mg，第2天为980mg，第3天为840mg。患者连续3天每天口服4mg地塞米松进行预处理。治疗持续至出现疾病进展证据或不可接受的毒性反应。每4周至少评估1次前列腺特异性抗原（PSA）水平。
患者接受化疗的中位周期数为3个。在可评估的46例患者中，25例（54%）PSA下降≥50%，12例（26%）PSA下降≥75%。PSA进展的中位时间和总生存时间分别为10.1个月和27.0个月。中位随访时间为15.0个月。主要严重毒性反应为5例（11%）患者出现3或4级白细胞减少。轻度毒性反应包括8例（17%）患者出现1或2级恶心。2例患者分别因间质性肺炎和胃出血而无法继续治疗。
多西他赛联合雌莫司汀化疗对日本HRPC患者是一种有效的且耐受性良好的治疗方法。
