Department of Urology, Shanghai Cancer Center, Fudan University, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Urology, Shanghai Cancer Center, Fudan University, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Kaohsiung J Med Sci. 2014 Feb;30(2):82-5. doi: 10.1016/j.kjms.2013.07.004. Epub 2013 Aug 15.
Treatment options for patients with castration-resistant prostate cancer (CRPC) are limited. The purpose of our study was to investigate the safety and efficacy in terms of prostate-specific antigen (PSA) response of a low-dose oral combination of etoposide and prednisone in patients with CRPC. Thirty-nine patients with prostate cancer (median age, 77.9 years) with progressive disease after standard hormonal therapy were enrolled. Etoposide (25 mg, twice daily) and prednisone (5 mg, twice daily) were administered orally. Each cycle comprised 21 consecutive days of treatment followed by a 7-day drug holiday. All patients previously treated with an antiandrogen were required to undergo antiandrogen withdrawal prior to entry into the study. A total of 226 cycles were administered with a median of 6.7 cycles per patient (range, 1-18 cycles). Sixteen of 39 patients (41%) with elevated PSA levels at baseline achieved at least a 50% reduction in PSA levels. Median progression-free survival for all patients was 5.9 months (range, 1-17 months). No Grade 4 toxicities were observed. The predominant toxicities were mucositis, nausea, fatigue, and anemia in twelve, nine, eight, and seven patients, respectively. Hematologic toxicity was infrequent, with no episodes of febrile neutropenia. The combination of low-dose etoposide and prednisone is an efficacious and reasonably well-tolerated oral regimen in the treatment of elderly patients with CRPC. This regimen can be easily administered in an outpatient setting and does not require frequent patient visits.
对于去势抵抗性前列腺癌（CRPC）患者，治疗选择有限。我们的研究目的是调查低剂量口服依托泊苷和泼尼松联合治疗 CRPC 患者在前列腺特异性抗原（PSA）反应方面的安全性和有效性。39 名患有前列腺癌的患者（中位年龄 77.9 岁）在标准激素治疗后疾病进展，入组本研究。依托泊苷（25mg，每日两次）和泼尼松（5mg，每日两次）口服给药。每个周期包括 21 天的连续治疗，然后停药 7 天。所有先前接受过抗雄激素治疗的患者在进入研究前都需要进行抗雄激素停药。共给予 226 个周期，中位每个患者 6.7 个周期（范围 1-18 个周期）。39 名基线 PSA 水平升高的患者中有 16 名（41%）至少达到 PSA 水平降低 50%。所有患者的中位无进展生存期为 5.9 个月（范围 1-17 个月）。未观察到 4 级毒性。主要毒性为 12 名患者出现黏膜炎、9 名患者出现恶心、8 名患者出现疲劳和 7 名患者出现贫血。血液学毒性不常见，无发热性中性粒细胞减少症发作。低剂量依托泊苷和泼尼松联合治疗是一种有效且耐受性良好的口服方案，可用于治疗老年 CRPC 患者。该方案可在门诊环境中轻松实施，无需频繁就诊。
