再燃前立腺癌に対するifosfamide(cyclophosphamide),adriamycin,cis-platinum,peplomycin併用療法(IAPP療法)の臨床成績

Abstract

1986年1月より4年3ヵ月間に15例に実施した.1)近接効果ではPRは15例中3例, PR+STは80%であった.奏効期間は2.8～18.0ヵ月, 中央値は5.7ヵ月であった.厚生省島崎班の薬物療法における臨床効果判定基準によればPR 6例, NC 6例, PD 3例であった.2)治療成績を前治療として化学療法施行群(化学内分泌療法も含む)と非施行群に分けて検討したが同等の成績であった.3) 2例に重篤な副作用を認めた.1例はPEPによる肺線維症により死亡し, 1例はIFOによる難治性の出血性膀胱炎をきたし尿路変

From January, 1986 to April, 1990, combination chemotherapy with ifosfamide (or cyclophosphamide), adriamycin, cis-platinum and peplomycin was performed in 15 patients with hormonally resistant metastatic adenocarcinoma. Three patients had partial response (PR) and 9 remained objectively stable (ST). The median response duration of PR + ST (12) was 5.7 months (range 2.8 to 18.0+). Three patients progressed while on this therapy. Of 8 patients with prior treatment of chemotherapy or chemo-hormonal therapy, 6 achieved an objective response (2 PR, 4 ST). Severe toxicities occurred in 2 patients. One died of lung fibrosis induced by peplomycin and the other received urinary diversion for persistent hemorrhagic cystitis. These results compare favorably with previous reports of chemotherapy treatment of metastatic prostatic cancer patients who failed on hormonal manipulation. However, careful treatment is needed for lung fibrosis and hemorrhagic cystitis.