多西他塞联合顺铂治疗晚期激素非依赖性前列腺癌的临床分析

Clinical results of chemotherapy applying docetaxel-cisplatin combination for advanced hormone independent prostate cancer

目的:探讨多西他塞加顺铂治疗晚期激素非依赖性前列腺癌的临床效果及毒副反应。方法:32例晚期激素非依赖性前列腺癌患者,均经去势手术或(和)抗雄激素药物治疗,患者血前列腺特异抗原(Prostate specific antigen,PSA)呈逐渐上升趋势。全身骨扫描证实均有多发性骨转移灶,其中26例出现不同程度的骨转移灶疼痛。多西他塞75mg/m2加生理盐水250ml静脉滴注,第1d用;顺铂100mg/m2加生理盐水500ml静脉滴注,第1d用。结果:治疗后患者血PSA值降至正常水平(<4ng/ml)8例,PSA值下降>50%13例,11例PSA值变化不明显,总有效率65%。26例骨转移灶疼痛者化疗后9例疼痛缓解,17例仍有疼痛。随访8～49个月,平均26.2个月,21例患者死亡,中位生存期18.6个月。疼痛缓解期平均13.9个月。常见毒副反应为恶心、呕吐、白细胞减少、血红蛋白降低及血小板减少等,但均在耐受范围。结论:多西他塞联合顺铂全身化疗治疗晚期激素非依赖性前列腺癌的临床疗效明显,毒副反应较轻,可作为晚期激素非依赖性前列腺癌的一种治疗方法。

Objective：To evaluate the efficacy and toxicity of docetaxel and cisplatin for treatment of hormone independent prostate cancer. Methods：Thirty-two cases hormone independant prostate cancer patients were enrolled in this study. All patients had received castration and/or anti-androgens but relapse with elevated PSA. Multiple metastasis were diagnosed by imaging approach. Before chemotherapy,there were 26 cases suffered from pain by bone metastasis. Docetaxel 75 mg/m^2 ＋ NS 250 ml was administered intravenously and cisplatin 100 mg/m^2 ＋NS 500 ml was administered intravenously on the first days. Results：Levels of PSA decreased to normal（〈4 ng/ml）in 8 patients,and decreased more than 50 in 13 patients,and did not change in 11 patient.The total effective rate was 65%. After chemotherapy,there were still 17 cases suffered from pain of bone metastasis.The patients were followed-up for 8～49 months（mean time 26.2 months）. Of 32 patients,21 patients died from the prostate cancer. The medium survival time was 18.6 months. Average time for remission of pain was 13.9 months. The toxicity of chemotherapy was tolerable,mainly nause,vomiting,leukopenia,decreased hemoglobin and thrombocytopenia. Conclusion：The docetaxel-cisplatin combination regime is effective and tolerable in the treatment for advanced hormone in dependent prostate cancer,it could be considered as one of the adjuvant treatment for advanced hormone independent prostate cancer.