前立腺癌治療における基調療法としてのホルモン剤と5-fluorouracil併用長期継続投与の効果に関する臨床的研究

Abstract

5-FUをホルモン剤(estrogenあるいはprogesterone)の少量と併用することの基調療法としての有効性をホルモン剤の大量投与の場合と比較した.5-FU 1日200 mgとgestagen (allylestrenolあるいはchloromadinone acetate)1日50 mgとの併用をestrogen (hexestrol) 1日60 mgと無作為分類した30名の未治療前立腺癌患者において比較したところ, 上記併用群における再燃率は20%, 平均有効期間は69ヵ月, 5年生存率は73%であったが, 大量のestrogen治療群の再燃率は60%, 平均有効期間は43ヵ月, 5年生存率は55%であった.再燃時における付加療法に対する反応性は両群においてほぼ半数にみられ, それらでは再び緩解が得られた.次にすでにhexestrol 1日60 mg投与により2年以上緩解状態にある26名の前立腺癌患者において5-FU 1日200 mgとhexestrol 1日30 mgとの併用群と, hexestrol 1日60 mg群とを比較したところ, 両群における再燃率はそれぞれ43%と50%, 平均有効期間は56ヵ月と52ヵ月, 5年生存率はともに59%であり, いずれも有意差はなかった

In the treatment of prostatic carcinoma, administration of some therapeutic agents, e.g. hormones, continuously as a basal treatment, and other proper treatment, e.g. irradiation or chemotherapy or both, were combined for occasional recurrence of the disease as additional treatment. Effectiveness of 5-fluorouracil in combination with hormones (estrogen or gestagen) in low doses, as a basal treatment, was compared with that of hormones alone in high doses. 5-Fluorouracil at 200 mg/day doses combined with gestagen (allylestrenol or chloromadinone acetate) at 50 mg/day doses was compared with estrogen (hexestrol) at 60 mg/day doses in 30 randomized patients with previously untreated prostatic carcinoma. On the other hand, 5-fluorouracil at 200 mg/day doses combined with hexestrol at 30 mg/day doses was compared with hexestrol at 60 mg/day doses also in 26 randomized patients with carcinoma already well controlled by hexestrol at 60 mg/day doses for more than two years. In patients of the former group treated with 5-fluorouracil and gestagen the rate of recurrence was 20%, mean effective period of therapy was 69 months and 5-year survival rate was 73%, although, in patients treated with high dose estrogen, the rate of recurrence was 60%, mean effective period was 43 months and 5-year survival rate was 55%. At occasional recurrence of the disease, in nearly half the patients in both groups, the disease responded to additional treatments and remission was obtained again. In patients of the latter group with already well controlled disease, no significant difference in prognosis was observed between patients treated with 5-fluorouracil plus low dose estrogen and those treated with high dose estrogen alone.(ABSTRACT TRUNCATED AT 250 WORDS)