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高剂量骨化三醇、多西他赛和唑来膦酸用于去势抵抗性前列腺癌患者:一项II期研究。

High-dose calcitriol, docetaxel and zoledronic acid in patients with castration-resistant prostate cancer: a phase II study.

作者信息

Shamseddine Ali, Farhat Fadi S, Elias Elias, Khauli Raja B, Saleh Ahmad, Bulbul Mohammad A

机构信息

Division of Hematology/Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. as04 @ aub.edu.lb

出版信息

Urol Int. 2013;90(1):56-61. doi: 10.1159/000343780. Epub 2012 Nov 8.

Abstract

INTRODUCTION

Docetaxel has become the standard chemotherapy for patients with castration-resistant prostate cancer (CRPC). We wanted to assess the efficacy and safety of a weekly high-dose calcitriol, docetaxel and zoledronic acid combination in CRPC.

PATIENTS AND METHODS

Thirty patients were enrolled to receive calcitriol 0.5 µg/kg orally in 4 divided doses over 4 h on day 1 of each treatment week, docetaxel 36 mg/m(2) i.v. infusion on day 2 of each treatment week and zoledronic acid 4 mg i.v. on day 2 of the first and fifth week of each cycle. Treatment was administered weekly for 6 consecutive weeks on an 8-week cycle.

RESULTS

Out of 23 evaluable patients, there was a response of prostate-specific antigen (PSA) in 11 patients (47.8%); 6 (26.1%) had a stable PSA level for a median of 4.2 months. The median survival time was 15 months (95% confidence interval 13.9-16.1 months). The regimen was generally tolerated; anemia was the only grade 3/4 hematological toxicity in 2 patients.

CONCLUSIONS

This regimen was tolerated, and half of the patients had a PSA response. Although our response rates are inferior to some studies using docetaxel, we believe our response rates are acceptable knowing that we are treating CRPC, which still has variable outcomes.

摘要

引言

多西他赛已成为去势抵抗性前列腺癌(CRPC)患者的标准化疗药物。我们旨在评估每周高剂量骨化三醇、多西他赛和唑来膦酸联合方案治疗CRPC的疗效和安全性。

患者与方法

30例患者入组,在每个治疗周的第1天,口服骨化三醇0.5µg/kg,分4次给药,4小时内完成;在每个治疗周的第2天,静脉输注多西他赛36mg/m²;在每个周期的第1周和第5周的第2天,静脉注射唑来膦酸4mg。每8周为一个周期,连续6周每周进行治疗。

结果

23例可评估患者中,11例(47.8%)前列腺特异性抗原(PSA)有反应;6例(26.1%)PSA水平稳定,中位时间为4.2个月。中位生存时间为15个月(95%置信区间13.9 - 16.1个月)。该方案总体耐受性良好;贫血是仅有的3/4级血液学毒性,2例患者出现。

结论

该方案耐受性良好,半数患者PSA有反应。尽管我们的反应率低于一些使用多西他赛的研究,但我们认为鉴于我们治疗的是CRPC,其结局仍存在差异,我们的反应率是可接受的。

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