進行前立腺癌に対するPeplomycinの持続皮下注入療法の検討

Abstract

持続注入器を用いたpeplomycinの持続皮下注入療法はほかの投与法に比較しすぐれた抗腫瘍性と低い肺毒性が期待できる.9例の再燃癌を含む17例のstage D前立腺癌例に本法を施行し, 4例のPR, 11例のstable diseaseを得た(2例は判定不可).肺症状は1例にみたのみであった.これらはpeplomycinを含め従来の化学療法に比し良好な結果である.今後持続注入器を用いたpeplomycinの持続皮下注入療法は進行前立腺癌のみならず, 広く前立腺癌の集学的治療の一環とすべき有効な治療法と考える

Continuous subcutaneous infusion of peplomycin was performed on 17 patients with metastatic prostate carcinoma, 9 of whom were refractory to conventional hormone therapy. Peplomycin was administered 5 mg daily through a newly-developed "microinfusion pump" for 14 consecutive days. This therapy was discontinued in 3 patients at the cumulative dose of 35, 35 and 55 mg. The mean cumulative dose was 84.7 mg. One patient who received 140 mg of peplomycin developed pulmonary fibrosis which was so mild that he recovered soon after the conservative therapy was instituted. There were no other episodes of pulmonary toxicities. Other major toxicities observed were anorexia (47%) and fever (41%). Of 15 patients who were evaluable with the response criteria of NPCP, 4 patients achieved objective partial regression (two for pulmonary metastases, one for bone metastases and the other for supraclavicular lymphnode metastases) and the other 11 patients remained stable. No progression of the disease was noted. Continuous subcutaneous infusion of peplomycin is advantageous over the bolus injection for increasing its anti-tumor activity as well as for decreasing its pneumotoxicity. It can also be performed for out-patients without difficulty. We believe this therapy should be incorporated in the multidisciplinary therapy of prostatic cancer.