前立腺癌stageD新鮮例に対するTegafur併用による内分泌化学療法の予後について

Abstract

前立腺癌stage Dの新鮮例66例に対し, 治療開始時より内分泌療法に加え, tegafurの併用を行い, 5年生存率を算出し検討した.1)実測生存率は31.2%, 相対生存率は39.2%で, 癌死のみについてみた実測生存率は47.5%であった.2)予後に係わる因子として初診時の年齢, PS, 前立腺組織の分化度が有意に関与していた.すなわち初診時65歳未満ではそれ以上に比し有意に予後が不良であった.PSでは車椅子や担送での入院者は独歩入院症例に比し有意に予後が不良であった.組織学的には低分化型および中分化型は高分化型に比しその予後は有意に不良であった

To study the effect of tegafur administration combined with hormonal therapy on the survival rate of newly diagnosed patients with stage D prostatic cancer, 66 patients, 70.9 years old in mean age, were treated from 1979 to 1986. The cancer was proven by the histological or cytological examination of the specimen which was obtained by the needle biopsy and/or aspiration biopsy of the prostate. The histopathological diagnosis of 59 patients was as follows: well differentiated type of adenocarcinoma was observed in 13 patients, moderately differentiated type in 19 cases, poorly differentiated type in 24 cases and mixed type in 3 cases. Daily 600 mg tegafur was administered orally as long as possible from the beginning of the treatment combined with hormonal therapy. Actual and relative 5 year survival rates calculated with Kaplan-Meier's method were 31.2% and 39.2%, respectively. When deaths other than prostatic cancer death were counted as lost cases, the actual survival rate was 47.5%. The present study also demonstrated that there were some factors affecting the patients' prognosis. They were the age of onset of the disease (patients under 64 years old were worse than those over 65 years old; p less than 0.05), performance status (patients with PS from 0 to 2 at the first admission were better than those with PS 3 to 4; p less than 0.025), differentiation of the tumor (well differentiated type was better than moderately; p less than 0.025 or poorly differentiated type; p less than 0.005).