エストラムスチンとシクロフォスファミドの併用で長期効果が得られている内分泌療法不応前立腺癌

The long-term effect of the combination of estramustine and cyclophosphamide to castration resistant prostate cancer：A case report

66歳時T2aN1M0，グリソンスコア4＋5の前立腺癌と診断し，内分泌療法後に根治的前立腺摘除術を施行した。術後も内分泌療法を継続したが不応となり，70歳時，PSA 17.38ng/mlの時点でエストラムスチン（EMP）とシクロフォスファミド（CPA）の併用を開始した。14か月後にはPSA＜0.01ng/mlとなり，24か月目に両剤を中止した。有害事象は軽度の骨髄抑制のみであった。41か月後の現在も0.02ng/mlで，画像的にも改善している。EMPとCPAの併用にて長期効果が得られていると考えた。

A 66-year-old man was diagnosed as prostate cancer of T2aN1M0,GS4＋5. After CAB,radical prostatectomy was performed,and hormonal therapy was continued after operation. However he gadually became non-respondent. At the time PSA become 17.38 ng/ml,combined application of estramustine（EMP）and cyclophosphamide（CPA）was started. PSA decreased gradually,and became below 0.01 ng/ml 14 months later,therefore both medicines were discontinued on the 24th month. Adverse effects were only slight bone-marrow suppression. After 41 months,PSA became 0.02 ng/ml,and bone abnormality by CT also improved. The long-term effect of EMP and CPA,to castration resistant prostate cancer patient was thus achieved.