Department of Urology, Texas Tech University Health Sciences Center, Lubbock, USA.
Cancer Treat Rev. 2011 Oct;37(6):444-55. doi: 10.1016/j.ctrv.2010.12.006. Epub 2011 Jan 28.
Castration-refractory prostate cancer remains a therapeutic challenge even after introduction of docetaxel as first-line treatment. Castration-refractory prostate cancer cannot be cured by any available therapeutic option, and chemotherapy still needs to be considered palliative. The survival benefit is modest, and treating physicians are searching for alternative treatment options. Despite new drugs currently under investigation, some conventional and well known chemotherapeutic drugs are experiencing a renaissance. The development of anti-angiogenic approaches in cancer treatment has led to the development of metronomic dosing of conventional chemotherapeutic drugs including cyclophosphamide. The intention of this review is to evaluate the efficacy and toxicity of oral/metronomic cyclophosphamide in the treatment of patients with castration-refractory prostate cancer.
A comprehensive literature search was performed in different databases using various key words. Relevant articles and references between 1962 and 2010 were reviewed and analyzed for data regarding the association between oral cyclophosphamide treatment and prostate cancer.
Oral cyclophosphamide is active in the treatment for castration-refractory prostate cancer even in patients treated with previous chemotherapy including docetaxel. It yields symptomatic and objective remissions. The side effects are usually grade 1-2 and easy to manage. Grade three to four side effects are less common.
Oral cyclophosphamide treatment for patients with castration-refractory prostate cancer deserves more attention and validation, and warrants further testing of various treatment combinations. Given the fact that castration-refractory prostate cancer includes an extremely heterogeneous group of patients with variability of tumor growth rates, the combination of cyclophosphamide with other active agents such as angiogenesis inhibitors and immunomodulatory compounds need to be explored.
即使在多西紫杉醇被引入作为一线治疗之后，去势抵抗性前列腺癌仍然是一个治疗挑战。去势抵抗性前列腺癌不能通过任何现有治疗方法治愈，化疗仍然需要被视为姑息治疗。生存获益是适度的，治疗医生正在寻找替代治疗方案。尽管目前正在研究新的药物，但一些传统和知名的化疗药物正在经历复兴。癌症治疗中抗血管生成方法的发展导致了包括环磷酰胺在内的常规化疗药物的节拍式给药的发展。本综述的目的是评估口服/节拍式环磷酰胺治疗去势抵抗性前列腺癌患者的疗效和毒性。
在不同的数据库中使用各种关键词进行了全面的文献检索。对 1962 年至 2010 年之间的相关文章和参考文献进行了回顾和分析，以获取关于口服环磷酰胺治疗与前列腺癌之间关联的数据。
口服环磷酰胺在治疗去势抵抗性前列腺癌中是有效的，即使在接受过包括多西紫杉醇在内的先前化疗的患者中也是如此。它能产生症状和客观缓解。副作用通常为 1-2 级，易于管理。3-4 级副作用较少见。
口服环磷酰胺治疗去势抵抗性前列腺癌值得更多关注和验证，需要进一步测试各种治疗组合。鉴于去势抵抗性前列腺癌包括一组具有肿瘤生长速度变化的极其异质的患者，需要探索环磷酰胺与其他活性药物（如血管生成抑制剂和免疫调节化合物）的组合。
