CDDPとADMによる前立腺癌, StageDの初期治療とその臨床効果について

Abstract

Stage Dの進行性前立腺癌20例の初期治療に際して, CDDP+ADM療法を試みた.島崎の基準による近接効果では, 前立腺の効果はpartial response (PR) 11例, no change (NC) 9例, 骨転移巣の効果はPR 1例, NC 16例, 軟部組織転移巣の効果はPR 5例, NC 1例, 前立腺性酸性フォスファターゼの効果はcomplete response (CR) 4例, PR 3例, NC 1例であり, 総合効果判定ではPR 13例, NC 7例であった.NPCPの基準ではPR 4例, NC 15例, PD 1例であった.遠隔成績では再燃を9例に認め, 制癌率は1年85.7%, 3年40.2%, 5年32.1%であり, 癌死は6例で生存率は1年100.0%, 3年64.3%, 5年53.6%であった.再燃, 癌死をきたした例は組織学的効果の乏しい例に生じる傾向がみられ, 組織学的効果は再燃, 癌死などの予後を決定する因子として重要である

From September 1983 to September 1989, 20 patients with newly diagnosed stage D prostatic cancer were treated with cis-platinum (CDDP) and adriamycin (ADM) as the induction therapy. Analysis of histological and clinical effects on the induction therapy revealed partial response (PR) in 13 cases and no change (NC) in 7 cases according to Shimazaki's response criteria, and PR in 4 cases, NC in 15 cases and progression (PD) in 1 case according to NPCP criteria. Histological Ef 0-b effect was found in 2 cases, Ef 1 in 7 cases, Ef 2 in 3 cases, Ef 3 in 2 cases and Ef 4 in 2 cases. Analysis of long-term results revealed relapse in 9 cases and cancer death in 6 cases. The 1-year, 3-year and 5-year continued response rates for all cases were 85.7, 40.2 and 32.1%, respectively. The 1-year, 3-year and 5-year survival rates were 100, 64.3 and 53.6% respectively. Histologically, low responsive cases showed a tendency of relapse and cancer death more frequently than high responsive cases. These results suggest that CDDP and ADM therapy is more effective than hormone therapy in newly diagnosed stage D prostatic cancer as an induction therapy.