Cis-Diamminedichloroplatinumの進行性前立腺癌に対する臨床的検討

Abstract

進行性前立腺癌20例にCis-Diamminedichloroplatinum (CDDP)を中心とした化学療法の近接効果を検討した.抗男性ホルモン療法非併用14例(6例のみ未治療新鮮例, 他13例はホルモン不応例)にCDDP 100～500 mg(平均208 mg)を静脈内投与11例, 動脈内投与1例, 両法併用2例に投与した.著効例はなく, 有効2例, やゝ有効7例, 無効5例であった.予後は生存例では7ヵ月が最長で, 極めて悪かった.さらに, 化学療法による良好な近接効果をうるための因子を検索し, また評価項目別に検討した.未治療のstage CまたはD例6例に去勢術, Diethylstilbestrol diphosphate, CDDP, IFM, ADMで100%の近接効果を得た

Chemotherapeutic effects of CDDP used as the main drug were studied in 20 patients with progressive prostatic cancer in stage C or D. On the average 208 mg of CDDP was given to the patients receiving chemotherapy without antiandrogen therapy (13 patients who showed resistance to hormone and an untreated new patient) and both ADM and IFM were also given to 3 of them. According to the criterion proposed by Shida and his coworkers, the chemotherapy without antiandrogen therapy was effective in 2 cases, relatively effective in 7 cases, and ineffective in 5 cases. The chemotherapy was effective for metastatic tumors of the lung in 2 out of 2 cases, but had no effect on tumors of the lymph node (1 case) and primary lesion of the tumors (14 cases). The chemotherapy improved acid phosphatase values in 5 out of 10 cases, alkaline phosphatase values in 3 out of 10 cases, dysuria in 4 out of 8 cases, nocturia in 1 out of 12 cases, residual urine in 5 out of 6 cases, lumbago in 6 out of 8 cases, and constitutional symptom in 6 out of 12 cases. The effect of the chemotherapy in combination with antiandrogen therapy was excellent in 4 and good in 2 of the 6 patients treated with castration + diethylstilbestrol diphosphate + CDDP + ADM +/- IFM. The chemotherapy with antiandrogen therapy had no effect on metastatic tumors of the bone (2 cases), but decreased the hardness and size of primary lesion in 6 out of 6 cases. Urethrography showed better changes in 6 out of 6 cases.(ABSTRACT TRUNCATED AT 250 WORDS)