前立腺癌内分泌療法中のホットフラッシュの対処法

Clinical evaluation of treatment for hot flushes developing during endocrine therapy in patients with prostate cancer

　ホットフラッシュ（HF）を訴える内分泌療法中の前立腺癌患者25例において，漢方薬，酢酸クロルマジノン，SSRI（selective serotonin reuptake inhibitor）のHF抑制効果を検討した。漢方薬は7例中4例（57％），酢酸クロルマジノンは10例中9例（90％），SSRIは11例中5例（45％）に有効であった。また3症例は複数の薬剤にて治療した。1例目では漢方薬およびSSRIは無効であったが，酢酸クロルマジノンは有効であった。2例目では酢酸クロルマジノンは無効，SSRIおよび漢方薬は有効であった。3例目では漢方薬および酢酸クロルマジノンともに有効であった。上記の薬剤はいずれも一定のHF抑制効果を示したが，症例により有効な薬剤は様々であることが示唆された。

We examined the efficacy of Kampo,chlormadinone acetate,and selective serotonin reuptake inhibitor（SSRI）for treatment of hot flushes（HF）that developed in 25 patients with prostate cancer undergoing endocrine therapy. As endocrine therapy,22 patients were with LHRH analogue and bicaltamide,2 patients with LHRH analogue and chlormadinone acetate,1 patient with LHRH analogue only.

In 4 of 7 patients（57％）receiving Kampo,9 of 10 patients（90％）receiving chlormadinone acetate（switched from bicaltamide）,and 5 of 11 patients（45％）receiving SSRI,HF disappeared or improved after 4 weeks treatment. In 3 patients,two drugs were examined. Neither Kampo nor SSRI,but chlormadinone acetate was effective in the first case. On the other hand,chlormadinone acetate was not effective but Kampo and SSRI were effective in the second case. Both Kampo and chlormadinone acetate were effective in the third case. In conclusion,Kampo,chlormadinone acetate,and SSRI were effective for the treatment of HF in prostate cancer patients,however the effective ness was thought to be different in each patient.（Rinsho Hinyokika 60：393-396,2006）