前立腺癌に対するペプロマイシンの臨床的検討

Abstract

In our department, 11 patients with prostatic carcinoma were treated with peplomycin, a derivative of bleomycin. They were aged from 62 to 84, and clinically classified (by the Whitemore classification) to 1 in stage A, 3 in stage B, 3 in stage C and 4 in stage D. Peplomycin was administered on the dosage schedule of 5 or 10 mg at a time, 3 times a week, to the target total dose of 180 mg. The effects of this drug against prostatic carcinoma were evaluated in terms of (1) changes in the size of the prostate, those in acid phosphatase activity and the trend of bone metastasis, (2) histopathological findings after the treatment, and (3) long-term survival. The adverse reactions to the treatment were also studied. The patients received peplomycin to the total doses of 80 to 190 mg (135 mg on the average). The drug was withdrawn from 5 of them for adverse reactions. At the end of the treatment, the prostate was found to have been reduced in size in 7, and unchanged in 3 of them. Acid phosphatase activity, which had been elevated in 5, was normal in all the 5 patients. Bone metastases had been noted in 4 of the 11 patients, but the clinical symptom (pain) had disappeared from all the 4 patients. The posttreatment histopathological findings of the prostate tissue specimens obtained by TUR were grade IIa in 1, grade IIb in 3, grade III in 4 and grade IVa in 3 of the patients by the Shimosato classification. Excluding 1 patient who died of an unknown cause 6 months after the end of the treatment and another of cerebral hemorrhage 7 months after the treatment, recurrence was noted 12 months after the treatment in one of the remaining 9 patients, while the other 8 have remained without any sign of recurrence for 2 to 25 months. The adverse reactions noted during the treatment consisted of dermatitis in 3 and interstitial pneumonitis in 5 patients; and the treatment was withdrawn from 5 of them. The interstitial pneumonitis was noted in the elderly patients aged 78 or more.