急速な病勢進行を認めるもカルボプラチン・パクリタキセル投与にて長期寛解が得られている前立腺癌の1例

Abstract

A 60-year-old man visited the previous hospital with difficulty of urination in July 2004. Serum prostate specific antigen (PSA) was 5.4 ng/ml and he was diagnosed with prostate adenocarcinoma, Gleason Score 4＋4＝8, cT1cN0M0. Although radical prostatectomy was recommended, he refused any treatment and never visited that hospital again. He was admitted to our hospital for exacerbation of dysuria with anal pain newly appeared in March 2005, when it was found that his disease had progressed to cT4N0M1b (thoracic spine, sacroiliac joint and ischium). Serum PSA decreased and the primary lesion shrunk after androgen deprivation therapy (ADT), whereas the left ischial lesion enlarged and serum carcinoembryonic antigen (CEA) and alkaline phosphatase (ALP) were elevated. For the castration-resistant progression, 30 Gy of local irradiation to the left ischial lesion and systemic chemotherapy with carboplatin (CBDCA) and paclitaxel (PTX) were administered, which led the patient to complete radiological and biochemical remission. The chemotherapy was discontinued in 2009 after the 18th course, and then ADT was also discontinued in 2010. The patient remains free from radiological or biochemical evidence of disease at the latest follow up in December 2014.