前立腺癌に対するEstramustine phosphate(Estracyt)の臨床的検討 - 長期投与38例の検討 -

Abstract

前立腺癌患者38人にEstracyt, 4 cap/日, 1年間以上継続投与した.Estracyt単独療法5例, 併用療法33例.全症例38例中10例(26.3%)に再燃がみられ, 再燃までの期間は平均20.8ヵ月であった.再燃した10例中, 3例は癌死, 1例は他因死, 残り6例は生存中, 再燃から死亡までの期間は平均7ヵ月であった.全症例38例中5例(13.2%)が死亡し, 1年生存率97.4%, 3年生存率88.5%, 5年生存率68.8%であった.stage A～Cの症例はstage Dより生存率が高い傾向を, また高分化型の症例は, 低分化型より有意に高い生存率を示した.副作用を認めたものは14例(36.8%)であり, 女性化乳房が主なものであり, その他に消化器症状, 浮腫, 貧血, 動悸などを認めたが, 多くは対症療法, 減量等で継続投与が可能であった

Estramustine phosphate disodium (Estracyt) was used in the treatment of 38 patients with prostatic carcinoma for at least 1 year. Of these patients 37 patients were treated with Estracyt as primary treatment and 1 patient had been treated with another antiandrogenic therapy before the Estracyt treatment. Estracyt was given orally in a dose of 560 mg/day in divided oral doses. The clinical evaluation was done for the change of PAP, the relapse rate, the survival rate and the side effect. Among 22 cases which had shown abnormally high PAP values before the treatment started, the values decreased or normalized in 21 cases (95.5%) in the first year of administration of Estracyt. In 6 cases, however, the values increased again in the second year or later. Relapse was observed in 10 (26.3%) out of 38 cases. Relapse rate was 2.6%, 51.7%, and 51.7%, at the first, third, and fifth year, respectively. Survival rate was 97.4% at the first year, 88.5% at the third year, and 68.8% at the fifth year for the follow-up study. Side effects were observed in 14 (36.8%) out of 38 cases. The main side effect was gynecomastia. Gastro-intestinal disturbance and edema were also observed. However, there were only 2 cases (5.2%) in which administration of Estracyt had to be discontinued.