Minagawa Tomonori, Domen Takahisa, Suzuki Toshiro, Ueno Manabu, Nagai Takashi, Ogawa Teruyuki, Kiyokawa Hideo, Ishizuka Osamu
Department of Urology, Shinshu University School of Medicine.
Department of Urology, Suwa Red Cross Hospital.
Nihon Hinyokika Gakkai Zasshi. 2019;110(2):86-91. doi: 10.5980/jpnjurol.110.86.
(Purpose) Enzalutamide is one of the therapeutic options for castration-resistant prostate cancer (CRPC). However, general fatigue is frequently observed in patients after introduction of enzalutamide. Here, we used the Cancer Fatigue Scale (CFS) to monitor general fatigue after introduction of enzalutamide, and administered the Japanese herbal medicine (Kampo) drug, Hochuekkito, for management of general fatigue. (Materials and methods) Three patients with CRPC were enrolled in this retrospective observational study. The patients were all male, 72, 69, and 88 years old, respectively, and had received previous hormone therapy for CRPC. They complained of general fatigue 2-5 weeks after introduction of enzalutamide. The CFS was divided into three subcategories: physical fatigue, affective fatigue, and cognitive fatigue. Hochuekkito was prescribed for management of general fatigue. Moreover, 31 previous CRPC cases treated in our hospital were divided into a general fatigue group and a non-general fatigue group. The period of enzalutamide prescription was compared among the previous groups and the present three cases to determine the usefulness of Hochuekkito. (Results) In this series, CFS was useful to monitor general fatigue after introduction of enzalutamide. General fatigue after introduction of enzalutamide mainly consisted of physical fatigue, and improved in two of the three cases included in this study. However, enzalutamide was discontinued in one patient due to general fatigue. Fourteen of our 31 previous CRPC cases developed general fatigue after introduction of enzalutamide. The mean periods of enzalutamide prescription were 265.6, 173.2, and 193.0 days in the non-general fatigue, general fatigue, and the present three cases, respectively. The differences among the groups were not significant. (Conclusions) The CFS is useful to monitor general fatigue, including its subcategories, after introduction of enzalutamide in patients with CRPC. The Kampo medicine Hochuekkito may be useful for management of general fatigue in such cases.
（目的）恩杂鲁胺是去势抵抗性前列腺癌（CRPC）的治疗选择之一。然而，在使用恩杂鲁胺后，患者经常出现全身疲劳。在此，我们使用癌症疲劳量表（CFS）来监测使用恩杂鲁胺后的全身疲劳情况，并给予日本草药（汉方）药物补中益气汤来管理全身疲劳。（材料与方法）三名CRPC患者纳入了这项回顾性观察研究。患者均为男性，分别为72岁、69岁和88岁，之前均接受过CRPC的激素治疗。他们在使用恩杂鲁胺后2 - 5周出现全身疲劳。CFS分为三个子类别：身体疲劳、情感疲劳和认知疲劳。给予补中益气汤用于管理全身疲劳。此外，将我院之前治疗的31例CRPC病例分为全身疲劳组和非全身疲劳组。比较之前这些组与目前这三例患者的恩杂鲁胺用药时间，以确定补中益气汤的有效性。（结果）在本系列研究中，CFS有助于监测使用恩杂鲁胺后的全身疲劳情况。使用恩杂鲁胺后的全身疲劳主要由身体疲劳组成，本研究纳入的三例患者中有两例有所改善。然而，有一名患者因全身疲劳而停用恩杂鲁胺。我们之前的31例CRPC病例中有14例在使用恩杂鲁胺后出现全身疲劳。非全身疲劳组、全身疲劳组和目前这三例患者的恩杂鲁胺平均用药时间分别为265.6天、173.2天和193.0天。各组之间的差异不显著。（结论）CFS有助于监测CRPC患者使用恩杂鲁胺后的全身疲劳情况，包括其子类别。汉方药物补中益气汤可能有助于管理此类患者的全身疲劳。
