Stage D2前立腺癌の内分泌療法 総アンドロゲン除去に用いる薬剤の比較―

Abstract

Stage D2前見腺癌に対し初回治療として, 外科的去勢術又はLHRHアナログ剤に併用薬剤としてエストロゲン剤, 酢酸クロルマジノン, 又はフルタミドのいずれか一つを用いた患者の予後を比較した.3群間に全生存率も癌特異別生存率にも差がなかった.各群を組織学的分化度, 骨転移の拡がり(EOD)及び腫瘍マーカー値について二分し, 各々について3群間比較をみたが差はなかった.有害事象についてフルタミドにgrade 2の肝機能障害が12%みられたほかは軽微であった.以上より総アンドロゲン除去(TAB)を目的としてエストロゲン, 酢酸クロルマジノン, 又はフルタミドのいずれを用いても同様の制癌効果が得られ, 差異は有害事象のみにあると結論した

Patients with Stage D2 prostate cancer were treated with surgical or medical (LHRH analog) castration combined with either estrogen, chlormadinone acetate or flutamide as initial therapy. The effect of each medication was compared. The overall survival, cause-specific survival and relapse-free survival were not different among the three medications. Patients given each medication were divided into two groups each according to grade, extent of diseases on bone metastases, and levels of tumor marker. Survivals of the corresponding two groups were compared with each other among different medications. No differences were revealed with any medication. There were no serious side effects in whole patients, except that grade 2 liver dysfunction was accompanied in 12% of flutamide-treated group. It is concluded that the three drugs used with castration did not make any difference in the survival of stage D2 patients, and differences between medications were seen in the frequency of side effects.