多西他赛、泼尼松联合氯磷酸二钠治疗激素抵抗性骨转移前列腺癌的近期疗效评估

Assessment on the short-term curative effects of docetaxe and prednisone combined with disodium clodronate in the treatment of hormone-refractory prostate cancer

目的：探讨多西他赛、泼尼松联合氯磷酸二钠治疗激素抵抗性骨转移前列腺癌（hormone refractory prostate cancer,HRPC）的近期疗效和毒副反应。方法：26例HRPC患者接受以下方案化疗：多西他赛,75 mg/m2,静脉滴注,第1天;泼尼松5 mg,2次/d,1-21 d口服;3周为一疗程。氯磷酸二钠（固令）1片2次/d全程服用,满3周期化疗后,比较化疗前后血清总前列腺特异性抗原总前列腺特异抗原（total prostate specific antigen,TPSA）、骨痛评分、骨密度及可测量病灶的变化等,并观察本化疗方案的不良反应。结果：26例患者中TPSA降低反应有效17例,总有效率65.4%;26例患者伴骨痛患者化疗后有21例明显缓解,其疼痛数字评分（numeric rating scales,NRS）平均值由5.13分降至2.8分;10例有可测量转移病灶患者中有6例病灶显著缩小。化疗不良反应主要为骨髓抑制、手足综合征和胃肠道反应等。结论：多西他赛、泼尼松联合氯磷酸二钠治疗HRPC疗效确切,毒副反应可耐受。

Objective：To explore the short-term curative effects and side effects of docetaxe and prednisone combined with disodium clodronate in the treatment of hormone refractory prostate cancer（HRPC）. Methods：Twenty-six patients with HRPC were enrolled in this study and received the following treatments：docetaxe（75 mg/m2,intravenously）on d1;prednisone（5 mg twice per day,preorally）on d1-d21 and disodium clodronate（one pill twice per day）on on d1-d21. After a 3-week cycle,the parameters of total prostate specific antigen（TPSA）,pain score,bone mineral density and measurable metastasis were examed after the chemotherapy cycle and the side effects being observed. Results：Of the 26 patients,TPSA was decreased in 17 patients（65.4%）. Among 26 patients with bone pain,remarkable pain relief was seen in 21 patients and the average numeric rating scale was decreased from 5.13 to 2.8. After the chemotherapy,the maximum diameter of metastatic tumor was reduced significantly in 6 out of 10 patients. The side effects of the chemotherapy were mainly myelosuppression,hand-foot syndrome and gastrointestinal reactions. Conclusion：The docetaxel-prednisone-disodium clodronate combination regime is effective and tolerable in the treatment for advanced hormone- refractory prostate cancer.