호르몬 불응성 전립선암에서 Estramustine을 기본으로 하는 항암화학요법
Estramustine Phosphate Based Chemotherapy for Hormone Refractory Prostate Cancer
한경석, 조강수, 이승환, 홍성준,
소속 상세정보
한경석 ( Han Kyung-Seok )
연세대학교 의과대학 비뇨기과학교실
조강수 ( Cho Kang-Su )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
이승환 ( Lee Seung-Hwan )
연세대학교 의과대학 비뇨기과학교실
홍성준 ( Hong Sung-Joon )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
KMID : 0358320070480070684
Abstract
Purpose: We wanted to evaluate the efficacy and side effects of estramustine monotherapy and estramustine plus etoposide or dexamethasone combined therapies for patients with hormone refractory prostate cancer(HRPC).
Materials & Methods: Between 2000 and 2004, 33 patients who were diagnosed with HRPC and treated with estramustine-based chemotherapy were evaluated. Eleven patients had oral estramustine monotherapy(group 1), 12 patients had oral estramustine plus oral etoposide(group 2), and finally 10 patients had oral estramustine plus oral dexamethasone(group 3). The prostate-specific antigen(PSA) response, progression-free survival and disease-specific survival were evaluated.
Results: The median patient age was 71 years and the median PSA was 97.3ng/ml. The median follow-up period was 17 months(range: 5-47). The overall response rate was 45.5%, and the response rate for each group was 36.4% for group 1, 41.7% for group 2 and 70.0% for group 3, respectively. The median time to progression(TTP) was 5 months(range: 1-16) overall and it was 5 months, 5.5 months and 5 months in groups 1, 2 and 3, respectively. Regarding the response rate, progression-free survival and disease specific survival, there were no statistically significant differences between the three groups(p＞0.05). The most common hematologic complication was anemia that occurred in 28 patients and deep vein thrombosis occurred in 2. Severe toxicities(≥grade 3) occurred in only 2 patients.
Conclusion: Estramustine phosphate showed over a 45% response rates with less morbidities. Estramustine-based chemotherapy can be considered as an option for the treatment of HRPC. However, larger randomized controlled trials for regimens combined with other efficacious agents are necessary to elucidate the efficacy of chemotherapy for HRPC.(Korean J Urol 2007;48:684-690)
키워드
Prostate cancer;Chemotherapy;Estramustine;Etoposide;Dexamethasone
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