Mohler J L, Williams B T, Thompson I M, Marshall M E
University of North Carolina, Chapel Hill 27599-7235.
J Cancer Res Clin Oncol. 1994;120 Suppl(Suppl 1):S35-8. doi: 10.1007/BF01377123.
The unavailability of effective treatment for metastatic hormone-refractory and clinically localized but pathologically unfavorable prostatic carcinoma warrants trial of new and promising treatments. Preliminary studies in patients with metastatic disease have shown (a) subjective but no objective responses to 100 mg coumarin and cimetidine daily; (b) objective responses in 3 of 40 patients treated with 3 g coumarin daily, all of whom had normal performance status and 1 of whom remains with three resolved bone metastases and stable prostate-specific antigen levels after 4 years; (c) toxicity only in bedridden patients. We recently initiated two multi-center trials of 1 g coumarin daily. Metastatic prostatic carcinoma patients of normal performance status were treated in a phase II trial. Patients who had been treated by radical prostatectomy, but had surgical margin, seminal vesicle or lymph node involvement or detectable prostate-specific antigen after radical prostatectomy, were randomized to coumarin or placebo.
对于转移性激素难治性以及临床局限性但病理特征不良的前列腺癌，目前尚无有效的治疗方法，因此有必要尝试新的、有前景的治疗手段。对转移性疾病患者的初步研究表明：（a）每天服用100毫克香豆素和西咪替丁，患者有主观反应，但无客观反应；（b）每天服用3克香豆素治疗的40例患者中有3例出现客观反应，所有这些患者的身体状况均正常，其中1例在4年后仍有三处骨转移灶消失且前列腺特异性抗原水平稳定；（c）仅卧床患者出现毒性反应。我们最近启动了两项每天服用1克香豆素的多中心试验。身体状况正常的转移性前列腺癌患者参与了一项II期试验。接受过根治性前列腺切除术，但存在手术切缘、精囊或淋巴结受累情况，或在根治性前列腺切除术后可检测到前列腺特异性抗原的患者，被随机分为香豆素组或安慰剂组。
