Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.
Jpn J Clin Oncol. 2011 Feb;41(2):253-9. doi: 10.1093/jjco/hyq178. Epub 2010 Nov 10.
To evaluate the clinical utility of an oral combination of dexamethasone, uracil plus tegafur and cyclophosphamide as a treatment for patients with hormone-refractory prostate cancer.
Fifty-seven patients with hormone-refractory prostate cancer were treated with an oral administration of dexamethasone (1.0 mg/day), uracil plus tegafur (400 mg/day) and cyclophosphamide (100 mg/day). The median patient age was 71 years. Sixteen patients had symptomatic bone metastasis, 31 had asymptomatic bone metastasis and 8 showed lymph node metastasis. Eight patients presented with only biochemical progression as evaluated by serum prostate-specific antigen levels.
Thirty-six (63%) of 57 patients demonstrated a ≥50% decline in serum prostate-specific antigen levels. The median time to prostate-specific antigen progression was 7.2 months. In patients with a prostate-specific antigen decline of ≥50%, the median time to progression was 13.3 months. With respect to pre-treatment markers, the duration of response to initial hormonal treatment was associated with the time to prostate-specific antigen progression. In 11 of 16 (69%) patients who complained of bone pain, the pain improved and became stable in 5 of those patients (31%). Most adverse events were mild and only three (5%) patients showed neutropenia of Grade 3 or higher.
The combination of dexamethasone, uracil plus tegafur and cyclophosphamide is an effective and well tolerated regimen for hormone-refractory prostate cancer. To evaluate the survival benefits, further randomized studies are required.
评估地塞米松、尿嘧啶加替加氟和环磷酰胺口服联合治疗激素难治性前列腺癌的临床应用价值。
57 例激素难治性前列腺癌患者接受地塞米松（1.0mg/天）、尿嘧啶加替加氟（400mg/天）和环磷酰胺（100mg/天）口服治疗。中位患者年龄为 71 岁。16 例有症状骨转移，31 例无症状骨转移，8 例有淋巴结转移。8 例患者仅根据血清前列腺特异性抗原水平评估为生化进展。
57 例患者中有 36 例（63%）血清前列腺特异性抗原水平下降≥50%。前列腺特异性抗原进展的中位时间为 7.2 个月。在前列腺特异性抗原下降≥50%的患者中，进展的中位时间为 13.3 个月。就治疗前标志物而言，初始激素治疗的反应持续时间与前列腺特异性抗原进展时间相关。在 16 例（69%）抱怨骨痛的患者中，11 例患者的疼痛得到改善，其中 5 例（31%）疼痛稳定。大多数不良事件为轻度，仅 3 例（5%）患者出现 3 级或更高的中性粒细胞减少症。
地塞米松、尿嘧啶加替加氟和环磷酰胺联合治疗是一种有效且耐受良好的激素难治性前列腺癌治疗方案。为了评估生存获益，需要进一步的随机研究。
