アンチアンドロゲン除去症候群を認めた後10年以上の長期寛解を得ているstage D2前立腺癌

Complete response, as determined by prostate-specific antigen level, to bicalutamide withdrawal persisting longer than 10 years in patient with advanced prostate cancer : A case report

　66歳男性．検診PSA 929ng／mLにて初診となった．精査にて多発性骨転移を伴うstage D2前立腺癌として，リュープロレリン酢酸塩，ビカルタミドによるホルモン療法を開始した．治療後PSAは下降したが，27か月目に再燃を認め，ビカルタミドの内服を中止した．中止後アンチアンドロゲン除去症候群（AWS）を認め，以後10年PSA再燃を認めていない．この間，画像では初診時に認めた前立腺の変形，骨転移は消失していた．

Abstract

A 66-year-oldman visited own hospital due to high PSA on medical chekup. His PSA level was 929ng/mL. Prostate needle biopsy revealed a histological diagnosis of adenocarcinoma, Gleason score3 + 4 = 7 and bone scintigraphy showed multiple bone metastasis. Under the diagnosis of stage D2 prostate cancer, combined androgen blockade using bicalutamide and leuprorelin acetate was given. His PSA concentration dicreased,but increased to a level of recurrence, as determined by PSA on 27 month after initiation of CAB. The administration of bicalutamide was discontinued and PSA concentration decreased again to a level of complete response as determined by PSA. Complete response, as determined by PSA, to bicalutamide withdrawal is persisting longer than 10 years (Rinsho Hinyokika 70 : 281-284, 2016).