磷酸雌二醇氮芥联合非那雄胺治疗激素难治性前列腺癌疗效观察  

Efficacy of combined use of oral estramustine and finasteride in treatment of patients with hormone refractory prostate carcinoma

作　　者：王荫槐[1] 张选志[1] 赵小昆[1] 杨罗艳[1] 刘任[1] 

机构地区：[1]中南大学湘雅二医院泌尿外科,湖南长沙410011

出　　处：《中国肿瘤临床与康复》2007年第5期461-463,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的观察联合应用磷酸雌二醇氮芥（EMP）和非那雄胺7台疗激素难治性前列腺癌的疗效。方法1999年7月至2006年1月联合应用EMP和非那雄胺治疗激素难治性前列腺癌14例。治疗方案：EMP280mg，每日2次；非那雄胺5mg，每日1次，28d为一疗程，连续应用直至毒副反应无法耐受或治疗失败。疗效判断标准：血前列腺癌胚抗原（PSA）下降〉50％且维持1个月以上为有效，软组织转移灶疗效分为痊愈、好转、稳定和进展。结果14例随访3～24个月，平均13个月。PSA有效率57．1％（8／14），有效患者PSA从治疗前（53．6±42．3）ng／ml下降至治疗后3个月（12．8±9．5）ng／ml，平均有效时间9个月。软组织转移灶好转者3例，转移灶分别从治疗前2．0cm×2．5cm、3．5cm×4．5cm、4．5cm×4．0cm缩小为1．0cm×1．0cm、2．0cm×2．5cm、2．0cm×3．0cm，有效持续时间分别为5、9、12个月。结论联合应用EMP和非那雄胺治疗激素难治性前列腺癌有一定疗效。Objective To evaluate the efficacy of oral estramustine phosphate combined with oral finasteride in the treatment of hormone refractory prostate cancer （HRPC）. Methods From July 1998 to January 2006,14 patients （age range ,65-83 years, mean age 71 years）with HRPC were treated with oral estramustine phosphate （280 mg, bid） and oral finasteride （5 mg, qd）for 28 days as a cycle. The therapy continued until there was evidence of side effects that the patients could not bear or treatment failure. The outcome measure included PSA level decrease by 〉 50% for more than 1 month as effective, and the efficacy for soft tissue metastases was classified as complete remission, partial remission, stabilization and progression. Resuits All patients were followed up for 3-24 months （mean, 13 months）, PSA level decreased by at least 50% in 8 of 14 cases （57.1%）. It decreased from （53.6±42.3） ng/ml before treatment to （ 12.8 ±9.5 ） ng/ml after 3 months of treatment,with a mean duration of response being 9 months. Partial remission of soft tissue metastases was obtained in 3 cases. The metastatic lesions were reduced from 2.0 cm × 2.5 cm, 3.5 cm×4.5 cmand4.5 cm×4.0cm to 1.0cm×1.0cm,2.0cm×2.5 cm and 2.0cm × 3.0cm respectively,with response duration being 5,9 and 12 months, respectively. Conclusion The combination of oral estramustine phosphate and oral finasteride may be an effective regimen for treatment of patients with HRPC.

关 键 词：前列腺肿瘤/药物疗法 磷酸雌二醇氮芥 非那雄胺 

分 类 号：R737.25[医药卫生—肿瘤] R730.53[医药卫生—临床医学]