多西紫杉醇联合卡铂治疗激素抵抗性前列腺癌近期疗效观察

Combination of Docetaxel and Carboplatin in Patients with Hormone Refractory Prostate Carcinoma

目的:探讨多西紫杉醇联合卡铂治疗激素抵抗性前列腺癌的应用价值。方法:12例前列腺癌患者,全部经去势手术及不同程度的抗雄激素药物治疗,经全身骨扫描证实均有多发性骨转移灶,颈部淋巴结转移和肝转移各1例,血PSA呈逐渐上升趋势。给予多西紫杉醇75mg/m2,第一天;卡铂AUC5(300～400 mg/m2),第一天;21—28天为一个周期。结果:12例随访2～26个月,平均17个月。入组后接受治疗1～6个周期。3例患者PSA值降至正常水平<4ng/ml,7例PSA值下降超过50%,有效率83.3%,有效患者PSA从治疗前(67.8±35.9ng/ml)下降至(14.2±5.7ng/ml),有效持续时间6～19个月,平均15.1个月。中位生存期为17.8个月。最常见的毒副反应为骨髓抑制,其余反应均可耐受。结论:多西紫杉醇联合卡铂治疗激素抵抗性前列腺癌有较好疗效,毒副反应可以耐受。

Objective： To evaluate the efficacy of docetaxel combined with carboplatin for the treatmentof hormone refractory prostate cancer（HRPC） . Methods： Oct 2004 and Dec 2006, From 12 patients （mean age, 65 years, age range, 54-73 years ） with HRPC were treated with docetaxel （75mg/m^2） and carboplatin （AUC5, 300-400mg/m^2） for 21 days or 28 days as a circle. Results All patients were followed up for 2 - 30 months, mean 17 months with the evaluation of efficacy and toxicity. PSA levels decreased by at least 50% in 7 of 14 cases, to normal titer （〈 4ng/l） in 3 patients, and did no change in 2 patients. It decreased from （67.8±35.9ng/ml） before treatment to （14.2±5.7ng/ml） after treatment, with a mean duration of response being 15.1 months （ range, 6 - 19 months）. The median survival time was 17.8 months. The main toxicities were hematological toxicities, the other side effects were well-tolerated. Conclusion：Combined chemotherapy of docetaxel and carboplatin might be a good regimen for advanced prostate cancer with good efficacy and well-tolerated side effects.