Otto T, Rembrink K, Goepel M, Krege S, Meyer-Schwiekerath M, Rübben H
Urologische Klinik, Medizinische Einrichtungen der Universität, Gesamthochschule Essen.
Urologe A. 1996 Mar;35(2):142-5.
So far, no curative treatment is available for hormone-refractory prostate carcinoma. Therapy is thus focused on alleviating symptomatic tumor progression with the aim of improving quality of life. Therefore, anthracyclin-derived mitoxantrone was administered to 25 patients with hormone-refractory prostate carcinoma and symptomatic progressive disease. After a median treatment of 13 weeks, a median of 4 cycles and a follow-up of 14 months, 48% of the patients (12/25) reported improvement in tumor-related pain; in 60% (15/25) there was improvement of the self-assessment symptom score and 32% of the patients (8/25) gained weight. Additionally, partial tumor response with regression of lymph-node metastases occurred in 3/25 patients (12%). In 10/25 patients the serum level of prostate-specific antigen (PSA) decreased as well as the alkaline phosphatase (AP) in 7/25 patients. Side effects subsequent to chemotherapy were leucopenia WHO grade III in 25% of the patients and thrombocytopenia WHO grade III in 3/25 and grade V (treatment-related death) in 1/25 patients. Non-hematological toxicity occurred in 2 patients (cardiotoxicity n = 1, nephrotoxicity n = 1, WHO grade II each).
到目前为止,激素难治性前列腺癌尚无治愈性治疗方法。因此,治疗的重点是缓解症状性肿瘤进展,目的是提高生活质量。为此,对25例激素难治性前列腺癌且有症状性疾病进展的患者给予了蒽环类药物米托蒽醌。经过中位13周的治疗、中位4个周期以及14个月的随访,48%的患者(12/25)报告肿瘤相关疼痛有所改善;60%(15/25)的患者自我评估症状评分有所改善,32%的患者(8/25)体重增加。此外,25例患者中有3例(12%)出现部分肿瘤反应,伴有淋巴结转移灶缩小。25例患者中有10例血清前列腺特异性抗原(PSA)水平下降,25例患者中有7例碱性磷酸酶(AP)水平下降。化疗后的副作用包括25%的患者出现世界卫生组织(WHO)III级白细胞减少,25例中有3例出现WHO III级血小板减少,25例中有1例出现V级(与治疗相关的死亡)。2例患者出现非血液学毒性(心脏毒性1例,肾毒性1例,均为WHO II级)。