未治療前立腺癌(低分化型, Stage D2)に対するEstrogen剤とUFTの併用療法

Abstract

低分化型, stage D2前立腺癌34例において, estrogen剤単独投与群とestrogen剤+UFT投与群の生存率・非癌死率の比較検討を行った.全体としては差が無く, 又, 病理組織のWHO分類, 骨転移の程度及び腫瘍マーカーの正常化の有無という3つの項目に分けて検討した結果, 有意差はえられなかったが, ホルモン不応性要素の多いもの程, UFTを併用した方の成績が良い傾向を示した

To determine whether long-term oral administration of UFT, a combination of 5-fluorouracil and uracil, in addition to conventional estrogen therapy improved the response and survival of the patients with advanced stage D2 prostate adenocarcinoma, a randomized prospective study was performed with either estrogen alone (Honvan 200 mg/day or presexol 1 mg/day: group A) or estrogen plus UFT (400 mg/day:group B). This study comprises 34 newly diagnosed patients with poorly differentiated prostatic adenocarcinoma (18 patients in group A and 16 in group B). Survival from all causes of death or cancer-specific death were compared using Kaplan-Meier actual methods among the patients separated by histological composition of tumors analyzed WHO histologic patterns, score of extent of disease (EOD), and with or without normalization of serum PSA or PAP levels after treatment. Although combination therapy with UFT against overall survival was effective without statistical significance, better survival in this group than the patients treatment with estrogen alone assessed among the patients whose tumor contained more than 70% of medullary and/or column-cord histological components. The survivals among the patients with EOD score 3 and whose serum PSA or PAP levels did not lead to decrease within normal levels after treatment were also better in group B than in group A. These findings suggest the validity of the combination therapy with UFT in addition to estrogen against highly advanced prostatic cancer patients whose tumor composed of abundant non-hormone-refractor histological components.