多西他赛联合泼尼松治疗激素难治性前列腺癌

目的 观察多西他赛联合泼尼松3周方案治疗激素难治性前列腺癌的疗效.方法 2004年9月至2007年1月对13例激素难治性前列腺癌患者行多西他赛联合泼尼松3周方案化疗.患者69～82岁,平均75岁.入选标准：全雄激素阻断治疗失败,排除抗雄激素撤除综合症,并至少经过1次抗雄药物撤退以外的二线内分泌治疗无效.治疗方案：化疗第一天用多西他赛75 mg/m2,泼尼松5 mg,2次/d;从化疗第二天起泼尼松5 mg,2次/d,连续应用,21 d为1疗程.观察终点为血PSA、可测量病灶和疼痛的变化.结果 13例入组患者中1例失访,11例可评价疗效,PSA有效率为54%（6/11）,有效患者PSA从治疗前的23.6 ng/ml、515.5 ng/ml、150.0 ng/ml、16.4 ng/ml、152.7 ng/ml、12.3 ng/ml,下降到治疗后最低2.4 ng/ml、139.9 ng/ml、42.3 ng/ml、6.7 ng/ml、67.5 ng/ml、5.7 ng/ml.有效持续时间4个月、3个月、8个月、3个月、2个月、2个月.可测量病灶2例为稳定.骨痛改善率为50%（3/6）.12例可评价不良反应,主要不良反应为骨髓抑制,Ⅲ度白细胞减少占50%.12例中位随访194 d.死亡5例,已死亡患者从诊断激素非依赖性前列腺癌起中位生存期36个月.结论 多西他赛联合泼尼松3周方案治疗激素难治性前列腺癌有一定疗效,毒性可耐受.

Docetaxel plus prednisone for treatment of hormone refractory prostate cancer

Objective To evaluate the efficacy of docetaxel plus prednisone for the treatment of hormone refractory prostate cancer (HRPC). Methods Between September 2004 and January 2007, 13 patients (mean age, 75 years; range, 69-82 years) with HRPC were treated with prednisone (5 mg bid) and docetaxel (75mg/m2, at 3-week intervals). Inclusion criteria were previous complete androgen blockade, anti-androgen withdrawal evaluation, clinical or biochemical disease progression, and at least one time second line hormone therapy failure other than anti-androgen withdrawal. The end points were changes in PSA, pain and soft tissue metastases. Results Of the 13 patients, one patient was lost for follow-up, 11 patients were evaluated for therapeutic response and 12 patients were evaluated for toxicity. PSA levels decreased by at least 50% in 6 of the 11 patients ( 54%), from 23.6 ng/ml, 515.5 ng/ml,150.0 ng/ml, 16.4 ng/ml,152.7 ng/ml, and12.3 ng/ml before treatment to 2.4 ng/ml,139.9 ng/ml, 42.3 ng/ml, 6.7 ng/ml, 67.5 ng/ml and 5.7 ng/ml after treatment, with a duration of effective response being 4 months, 3 months, 8 months, 3 months, 2 months and 2 months. Measurable foci were stable in 2 patients. Bone pain was relieved in 50% of the patients. Grade 3 myelosuppression occurred in 50% of the patients. The median follow-up duration of the 12 follow-up patients was 194 days. Five patients died, with a median survival of 36 months from the day of diagnosis of AIPCa. Conclusions Docetaxel (at 3-week intervals) plus prednisone is an effective and well-tolerated regimen for patients with HRPC.