前立腺癌に対するEstramustine Phosphate(Estracyt)の使用経験

Abstract

Estramustine phosphate was used in the treatment of 21 patients with prostatic carcinoma. Of these 21 patients 15 were treated with estramustine phosphate as primary treatment (Group 1) and 6 had been treated with diethyl stilbestrol diphosphate and/or bilateral orchiectomy for more than 6 months before the estramustine phosphate treatment (Group 2). All patients were given a dosage of 560 mg per day in 2 divided oral doses and were assessed at the start of the therapy and at regular intervals during the study by clinical examination, blood chemistry, x-ray survey, bone scan and electrocardiogram. In several cases serum testosterone and triglyceride levels were estimated. An objective response was defined as a shrinkage of the primary tumor, fall to normal of the serum acid and alkaline phosphatase levels, disappearance of abnormality in urethrocystogram, significant reduction in residual urine and improvement of abnormal activity in bone scintigram. Subjective response was defined as improvement in the general condition and urinary disturbance and disappearance of bone pain. All of the 15 patients treated primarily with estramustine phosphate showed good objective and/or subjective response (100%), and of the 6 patients who received estramustine phosphate secondarily, 2 showed the objective response (33.3%). Two cases treated initially with estramustine phosphate and a estrogen resistant advanced case were reported in detail Gastrointestinal disturbance occurred in 9 patients and 12 patients of Group 1 had breast tenderness. Two patients showed elevated serum glutamic oxalacetic transaminase and glutamic pyruvic transamirase after 3 months of estramustine phosphate treatment. With cessation of therapy all hepatic function studies returned to normal. In previously untreated patients estramustine phosphate suppressed the serum testosterone levels. Oral estramustine phosphate is well tolerated and worthy of further clinical use but current clinical trial should be made to confirm the advantage over conventional estrogen therapy.