多西他赛加泼尼松耐药的前列腺癌联合雌二醇氮芥治疗22例报告  

Estramustine plus docetaxel and prednisone as second line therapy in patients with castration-resistant prostate cancer resistant to docetaxel plus prednisone

作　　者：孙忠全[1] 张正望[1] 钱伟庆[1] 宋建达[1] 徐俊[1] 盛璐[1] 周俊[1] 汪东亚[1] 丁海雍[1] 张豪杰[1] 戴文斌[1] 

机构地区：[1]复旦大学附属华东医院泌尿外科,上海200040

出　　处：《中国男科学杂志》2011年第8期36-39,共4页Chinese Journal of Andrology

摘　　要：目的观察对多西他赛加泼尼松方案耐药的去势抵抗性前列腺癌（Castration-Resistant Prostate Cancer，CRPC）病例联合应用雌二醇氮芥的疗效和安全性。方法CRPC患者22例在多西他赛加泼尼松治疗过程中病情进展（血PSA升高）时，用雌二醇氮芥联合多西他赛及泼尼松方案二线治疗：多西他赛75mg／m2，第1天，泼尼松5mgbid，第1天起连续应用，雌二醇氮芥280mgbid，第1天起连用5d。21d为1周期。主要观察终点是PSA，PSA下降〉50％为有效。次要观察终点包括生化无进展生存期、总生存期、客观有效率及毒副作用。结果22例患者共完成94个周期。有效14例，有效率64％。中位生化无进展生存期17．1周，中位总生存期54．3周。III-Ⅳ度毒副作用包括心脏毒性1例（5％），中性粒细胞减少8例（36％），粒细胞缺乏性发热1例（5％）。2例因毒副作用退出治疗。结论雌二醇氮芥联合多西他赛及泼尼松二线治疗多西他赛加泼尼松方案耐药的CRPC患者疗效较好，毒副反应可以耐受，值得进一步观察研究。Objective To investigate the efficacy and safety ofEstramustine/Prednisone/Docetaxel combination （E/P/D） as salvage chemotherapy for patients with metastatic castration-resistant prostate cancer （mCRPC） after the failure of Prednisone/Docetaxel （P/D）. Methods 22 CRPC patients for whom P/D treatment had failed received E/P/ D combination between November 2005 to June 2009. A decrease of〉50% in PSA was set as the primary endpoint. The toxicity profiles were also reviewed. Rusults Patients received a total of 94 cycles of E/P/D treatment. 64% patients had treatment response. The median biochemical progression-free survival was 17.1 weeks, and the median overall survival was 54.3 weeks. Despite grade 3-4 neutropenia in 36% of patients, this combination was in general tolerable. Conclusion Estramustine/Prednisone/Docetaxel combination is relatively active with acceptable toxicity profile as salvage treatment for mCRPC patients after the failure of P/D.

关 键 词：前列腺肿瘤 抗药性 肿瘤 抗肿瘤联合化疗立案 紫杉烷类 雌氮芥 

分 类 号：R737.25[医药卫生—肿瘤]