多西他赛联合雌二醇氮芥治疗激素抵抗性前列腺癌的疗效观察(附22例临床报道)  

The efficacy of combined chemotherapy of docetaxel and estramustine for advanced castration-resistant prostate cancer(report of 22 cases)

作　　者：崔殿生[1] 张克亮[1] 熊治国[1] 魏少忠[1] 闫玉虎[1] 

机构地区：[1]湖北省肿瘤医院泌尿外科,武汉430079

出　　处：《现代泌尿生殖肿瘤杂志》2013年第4期219-221,共3页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨多西他赛加雌二醇氮芥治疗去势抵抗性晚期前列腺癌的临床效果及不良反应。方法22例去势抵抗性晚期前列腺癌患者，全部经手术去势及不同程度的抗雄激素药物治疗后病情缓解，之后病情再进展，经全身骨扫描证实均有多发性骨转移灶，其中17例伴不同程度的骨转移灶疼痛。治疗方法：多西他赛75mg／m^2，第1天使用，雌二醇氮芥为420mg／d，第1～5天使用，每21天为一个疗程。结果5例患者的血PSA值降至正常水平（PsA〈4ng／L），12例PSA值下降超过50％，5例PSA值变化不明显。17例伴有骨转移灶疼痛的患者中有10例疼痛消失，7例疼痛患者按VRS分级分为I级4例、Ⅱ级3例。随访时间为8～26个月，平均17．3个月。8例患者死亡，中位生存期为14．7个月，平均疼痛缓解期为12．5个月；PSA值降低的稳定期平均为11．8个月。本组病例最常见的不良反应是恶心呕吐、白细胞减少、血红蛋白降低及血小板减少等，但均在可耐受的范围。结论雌二醇氮芥加多西他赛全身化疗治疗去势抵抗性晚期前列腺癌的近期疗效显著，不良反应可以耐受，值得进一步观察研究。Objective To evaluate the efficacy and toxicity of combined chemotherapy of do- cetaxel and estramustine for castration-resistant prostate cancer （CRPC）. Methods 22 patients with advanced CRPC, who received castration and antiandrogen medicines, were confirmed multiple bone metastatic carcinomas by emission computed tomography. 17 patients suffered from pain of bone metastasis. Docetaxel 75 mg/m2 in saline solution were administered by intravenous drip on day 1, estramustine 420 mg/d from day 1-5, repeat every 21 days. Results The PSA value de- scended to normal level 5 patients, descended more than 50% in 12 patients. After chemotherapy, 10 patients released from pain, only 4 suffered from pain of grade I and 3 patients are gradell. Pa- tients were follow-up for 8-26 months with a mean of 17. 3 months. 8 patients died of cancer, the median survival time was 14.7 months. Mean time of pain remission was 12.5 months and the stable period of PSA value descent was 11.8 months. Toxicities of chemotherapy were tolerable. Conclu- sions Combined chemotherapy of docetaxel and estramustine is effective with tolerable toxicities, profile as salvage treatment for CRPC patients.

关 键 词：多西他赛 雌二醇氮芥 前列腺癌 化学治疗 

分 类 号：R737.25[医药卫生—肿瘤]