세포독성 항암화학요법을 받을 수 없는 환자에서의 Estramustine Phosphate 단독요법
Estramustine Phosphate Monotherapy in Castration-Resistant Prostate Cancer Patients Who Cannot Receive Cytotoxic Chemotherapy
류재현, 김상진, 김윤범, 정태영, 문경태, 조정만, 유탁근,
소속 상세정보
류재현 ( Ryu Jae-Hyun )
Veterans Health Service Medical Center Department of Urology
김상진 ( Kim Sang-Jin )
Veterans Health Service Medical Center Department of Urology
김윤범 ( Kim Yun-Beom )
Veterans Health Service Medical Center Department of Urology
정태영 ( Jung Tae-Young )
Veterans Health Service Medical Center Department of Urology
문경태 ( Moon Kyong-Tae )
Eulji University School of Medicine Eulji General Hospital Department of Urology
조정만 ( Cho Jeong-Man )
Eulji University School of Medicine Eulji General Hospital Department of Urology
유탁근 ( Yoo Tag-Keun )
Eulji University School of Medicine Eulji General Hospital Department of Urology
Abstract
Purpose: To investigate whether estramustine phosphate (EMP) monotherapy is applicable to castration-resistant prostate cancer (CRPC) patients who cannot receive cytotoxic chemotherapy.
Materials and Methods: This retrospective single-arm study was conducted in CRPC patients who had not experienced cytotoxic chemotherapy and received EMP monotherapy (560 mg/day) at 2 institutions from 2008 to 2017. We analyzed prostate-specific antigen (PSA) responses, overall survival, and adverse effects of EMP treatment.
Results: A total of 28 patients were analyzed. A reduction in serum PSA was observed in 11 patients (39.3%). Seven cases (25.9%) achieved more than 25% reduction of PSA, and 5 of them (18.5%) experienced more than 50% reduction. Median overall survival was 23 months (interquartile range, 10?60 months). Multivariable analyses demonstrated that low level of PSA at diagnosis of CRPC and long duration of prior androgen deprivation therapy were independent favorable factors predicting long-term overall survival. Adverse effects were edema (n=2; grade 2), nausea/vomiting (n=1; grade 2), gynecomastia (n=1; grade 2), and dyspnea (n=1; grade 1). Neither thromboembolic event nor grade 3?5 toxicity was observed. There was no discontinuation caused by side effects of EMP.
Conclusions: EMP monotherapy could be considered as a safe treatment option with some effectiveness for CRPC patients who did not undergo cytotoxic chemotherapy. EMP is not generally recommended anticancer drug in the current guidelines for CRPC, but EMP monotherapy is thought to have an alternative role when a standard treatment cannot be selected due to patient's age, health condition, or comorbidity.
키워드
Castration-resistant prostatic neoplasm;Estramustine
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