Department of Urology, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, 565-0871, Japan.
Int J Clin Oncol. 2013 Aug;18(4):704-10. doi: 10.1007/s10147-012-0429-1. Epub 2012 Jun 12.
A low-dose chemotherapy consisting of docetaxel, estramustine and dexamethasone was investigated for its beneficial effect and feasibility in Japanese patients with metastatic castration-resistant prostate cancer (CRPC).
Seventy-two Japanese patients with metastatic CRPC were enrolled to receive docetaxel (25 mg/m(2) on days 2 and 9), estramustine phosphate (280 mg orally twice daily from day 1 to day 3 and from day 8 to day 10) and dexamethasone (0.5 mg orally twice daily) every 21 days.
The median age of the patients was 72 years and 64 patients (89 %) had ≥grade 1 anemia at entry. The median total number of courses administered was 8.5 (range 1-93). Forty-two patients (58 %) had a prostate-specific antigen (PSA) decline of ≥50 %. The median progression-free survival and overall survival were 6 and 23 months, respectively. Fifteen patients (21 %) improved and 53 patients (74 %) were stable in their performance status. Of the 40 patients with bone pain, 25 patients (63 %) showed pain reduction. Among 71 patients assessable for their hemoglobin levels, 21 patients (30 %) achieved an increase of at least 1.0 g/dl. Of the 5 patients who terminated treatment because of ≥grade 3 toxicity, 4 patients had pneumonitis and one patient had anemia. Only one patient developed ≥grade 3 neutropenia.
The low-dose combination of docetaxel, estramustine and dexamethasone is active and tolerable with beneficial effects on serum PSA levels, performance status, anemia and bone pain in Japanese patients with CRPC. This regimen is a reasonable option for elderly patients with bone disease at risk of hematologic toxicity.
一项包含多西他赛、雌莫司汀和地塞米松的低剂量化疗方案，因其对转移性去势抵抗性前列腺癌（CRPC）日本患者的疗效和可行性而被研究。
72 例转移性 CRPC 日本患者接受多西他赛（第 2 天和第 9 天 25mg/m²）、雌莫司汀磷酸盐（第 1 天至第 3 天和第 8 天至第 10 天每天口服 280mg，分两次）和地塞米松（每天口服 0.5mg，分两次）治疗，每 21 天为一个周期。
患者中位年龄为 72 岁，64 例（89%）患者入组时存在≥1 级贫血。中位治疗周期数为 8.5（范围 1-93）。42 例（58%）患者前列腺特异性抗原（PSA）下降≥50%。中位无进展生存期和总生存期分别为 6 个月和 23 个月。15 例（21%）患者的体能状态得到改善，53 例（74%）患者稳定。40 例有骨痛的患者中，25 例（63%）患者疼痛减轻。71 例可评估血红蛋白水平的患者中，21 例（30%）患者血红蛋白至少增加 1.0g/dl。因≥3 级毒性而终止治疗的 5 例患者中，4 例患者患有间质性肺炎，1 例患者患有贫血。仅有 1 例患者发生≥3 级中性粒细胞减少症。
多西他赛、雌莫司汀和地塞米松的低剂量联合方案在转移性去势抵抗性前列腺癌日本患者中具有活性和耐受性，对血清 PSA 水平、体能状态、贫血和骨痛具有有益作用。对于存在发生血液学毒性风险的骨病老年患者，该方案是一种合理的选择。
