Stage D2前立腺癌に対する内分泌化学療法 : 化学療法開始時期からみた有用性の検討

Abstract

シスプラチンを含む全身化学療法を用いて治療したステージD2前立腺癌患者29例を3群に分けた. 1)H群:ホルモン療法が化学療法より4週を越えて先行したもの(9例). 2)C群:化学療法がホルモン療法より4週を越えて先行したもの, 又は化学療法単独治療例(9例). 3)HC群:ホルモン療法と化学療法の関始時期の差が4週以内のもの(11例). Kaplan-Meier法による5年生存率は, H群が18%, C群が28%, HC群が78%で, HC群が他の2群に比べ良好であった

We retrospectively analyzed 29 patients with stage D2 prostatic cancer who had been treated with chemotherapy at the urological clinic of Tokyo Medical and Dental University Hospital between 1983 and 1992 to evaluate the efficacy of chemotherapy for advanced prostatic cancer. The patients were divided into three groups according to the starting time of chemotherapy in relation to hormone therapy; 9 patients who received chemotherapy more than four weeks after the initial hormone therapy (group H), 9 patients who received chemotherapy only or in combination with the hormone therapy more than four weeks previously (group C), and 11 patients in whom both therapies were started within four weeks (group HC). Follow-up period ranged from four to 108 months averaging 35. Combination chemotherapy including cisplatin was administered one to 17 times with the median of five. The five-year survival rates estimated by Kaplan-Meier method were 18% in group H, 28% in group C, and 78% in group HC, respectively (HC vs. C: p < 0.05, HC vs. H: p = 0.059). These findings indicate that a combination chemotherapy including cisplatin may improve the prognosis of patients with advanced prostatic cancer when it is started with the initial hormone therapy simultaneously.