去势加磷酸雌二醇氮芥治疗前列腺癌(附15例报告)

Conjoint use of castration and estracyte in the treatment of advanced prostatic cancer

目的探讨去势加磷酸雌二醇氮芥治疗不宜手术根治的前列腺癌的疗效。方法１９９０年１月～１９９６年５月采用去势加磷酸雌二醇氮芥治疗前列腺癌１５例，其中Ｂ２期５例，Ｃ期７例，Ｄ期３例。１５例均行双侧睾丸切除，术后口服磷酸雌二醇氮芥２８０ｍｇ／次，每日２次。结果随访２０～７９个月，平均４７个月。１３例取得客观疗效，１例肿块无明显缩小者因排尿困难行耻骨上膀胱造瘘，１例死于非瘤疾病。所有病例血常规化验未见骨髓抑制，１０例有乳房胀大。结论去势加磷酸雌二醇氮芥治疗前列腺癌效果较满意。

Objective To evaluate the effects of castration with the conjoint use of chemotherapy in the treatment of advanced prostatic cancer. Methods From Jan 1990 to May 1996, a total of 15 patients with advanced prostatic cancer were treated by bilateral orchiectomy and oral estramustine phosphate 280mg, twice a day. Follow up included subjective complaint, quality of life, white cell count, DRE, transrectal ultrasound, PSA testing and SPECT. Results The duration of follow up rang from 20 to 79 months (means 47 months). 13 cases achieved response with shrunk prostate and tumor volume on transrectal ultrasound detection, 3 patients with metastatic cancer in bone relieved of osteocope after 2 weeks treatment; 13 patients have been satisfied with the relieve of dysuria.Only 1 patient underwent cystostomy because of dysuria and another patient died of heart disease after 27 months. Hypermastia was noted in 10 cases. Hematologic toxicity was not observed.There has been no serious side effect requiring ceasing of the treatment. Conclusions The conjoint use of castration and chemotherapy with oral estracyte is safe and effective in the treatment of advanced prostatic cancer.