ホルモン抵抗性前立腺癌に対するリン酸エストラムスチン・エトポシド併用療法の検討

Oral estramustine phosphate and oral etoposide for the treatment of hormone-refractory prostate cancer

　リン酸エストラムスチン（EMP）・エトポシド（VP-16）併用療法をホルモン抵抗性前立腺癌11例に施行した。EMP 420mg/日，VP-16 50mg/日を3週内服，1週休薬を1クールとして投与し，原則とし外来通院とした。年齢は中央値74歳，治療開始時のPSA中央値は91.1ng/ml，治療は1～14クール施行した。5例（45％）でPSAが前値の50％以上低下した（Responders群）。全例での疾患特異的生存率は1年生存率61.4％，生存期間中央値は12か月，Responders群で有意に生存期間が延長した。有害事象が少なく外来治療も可能である本治療は，ホルモン抵抗性前立腺癌に有用と考えられた。

　We evaluated the efficacy and toxicity of oral estramustine phosphate（EMP）and oral etoposide（VP-16）in patients with hormone-refractory prostate cancer（HRPC）. Eleven patients with metastatic HRPC were treated with oral EMP 420mg/day and oral VP-16 50mg/day for 21 days,followed by discontinuance of treatment for 7 days,and the cycle was then repeated. The cycle of treatment was continued until evidence of disease progression or unacceptable toxicity was observed. Five of 11 patients（45％）demonstrated a 50％ decrease or more in pretreatment prostate-specific antigen（PSA）levels（responders）. The median survival time was 12 months and the 1-year overall survival rate was 61.4％ in all patients. The median survival time of responders was 13 months,which was significantly longer than non-responders. There was no significant difference between responders and non-responders in age,pretreatment PSA value or duration from initial treatment to relapse. The main toxicities were anemia,leukocytopenia and thrombocytopenia,which were observed in 27,27 and 8％ of patients,respectively. We conclude that the combination of oral EMP and oral VP-16 is an active and well-tolerated oral regimen in HRPC.（Rinsho Hinyokika 61：435-439,2007）