健择加顺铂全身化疗治疗激素非依赖性晚期前列腺癌的近期疗效

背景与目的:迄今为止,临床上仍需探索有效的治疗措施治疗激素非依赖性晚期前列腺癌。本研究拟探讨健择加顺铂治疗激素非依赖性晚期前列腺癌的临床效果及不良反应。方法:15例激素非依赖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12例有多发性骨转移灶,其中并有肝脏、双侧肾上腺和颅内转移各1例,血PSA进行性升高。用健择1000mg/m2加生理盐水(NS)100ml静脉滴注,第1、8天各一秦自科,等.健择加顺铂全身化疗治次;DDP100mg/m2加NS500ml静脉滴注第1天,或者DDP30mg+NS250ml静脉滴注第1～5天;每28天为一个疗程。结果:10例患者的血PSA值降至正常水平(<4ng/L),4例PSA值下降超过50%,1例PSA值变化不明显。化疗前12例有骨转移灶疼痛(按VRS分级Ⅰ级4例、Ⅱ级5例、Ⅲ级3例),化疗后9例疼痛消失,另3例仍有疼痛(Ⅰ级2例、Ⅱ级1例)。多发性颅内转移灶中最大转移瘤直径由化疗前的3.0cm缩小至0.5cm,化疗后面瘫症状消失。肝脏转移瘤由原先的10.2cm缩小至3.3cm。双侧肾上腺多发性转移瘤化疗后总的肿瘤体积缩小1/3以上。随访3～29个月,平均15.2个月,2例患者死亡,中位生存期14.7个月。平均疼痛缓解期为13.6个月。PSA值降低的平均稳定期为12.3个月。本组病例最常见

Short-term efficacy of combined chemotherapy of gemcitabine and cisplatin on advanced hormone refractory prostate cancer

BACKGROUND & OBJECTIVE: Effective treatment for hormone refractory prostate cancer was required. This study was to evaluate efficacy of combined chemotherapy of gemcitabine and cisplatin on hormone refractory prostate cancer, and its toxicities. METHODS: Fifteen patients with advanced hormone refractory prostate cancer,who received castration and antiandrogen medicines,were conformed multiple bone metastatic carcinomas by emission computed tomography (ECT). One patient had hepatic metastasis, 1 had adrenal metastasis, and 1 had intracranial metastasis. The value of prostate special antigen (PSA) was in an ascending trend in all patients. Gemcitabine of 1 000 mg/m(2) and normal saline solution (NS) of 100 ml were administered by intravenous drip on day 1, and day 8, cisplatin of 100 mg/m(2) and NS of 500 ml were administered by intravenous drip on day 1, or cisplatin of 30 mg/m(2) and NS of 250 ml were administered by intravenous drip from day 1 to day 5 within each 28-day cycle. RESULTS: Values of PSA in 10 patients descended to normal level (< 4 ng/L), those in 4 patients descended by more than 50%, and that in 1 patient had no change. Before chemotherapy, 12 patients suffered from pain of bone metastasis with 4 cases of grade I, 5 cases of grade II, and 3 cases of grade III. After chemotherapy, 9 patients released from pain,only 2 suffered from pain of grade I, 1 suffered from pain of grade II. The maximal diameter of multiple intracranial metastatic lesions was reduced from 3.0 to 0.5 cm, and the symptoms of facial paralysis vanished. Diameter of hepatic metastatic tumor was reduced from 10.2 to 3.3 cm, that of adrenal metastatic tumor was reduced by more than 2/3. Patients were followed-up for 3-29 months with a mean of 15.2 months. Of 15 patients, 2 died of the disease,the median survival time was 14.7 months. Mean time of pain remission was 13.6 months, and the stable period of PSA value descent was 12.3 months. Toxicities of chemotherapy were tolerable, including nausea/vomiting,leukopenia,decreased hemoglobin,and thrombo- cytopenia. CONCLUSIONS: Combined chemotherapy of gemcitabine and cisplatin is effective in treating advanced hormone refractory prostate cancer with tolerable toxicities, and could be considered as an adjuvant therapy for advanced hormone refractory prostate cancer.