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KMID : 1001020070050030159
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Korean Journal of Urological Oncology
2007 Volume.5 No. 3 p.159 ~ p.164
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Combination Chemotherapy with Paclitaxel, Estramustine and Etoposide for Hormone Refractory Prostatic Cancer
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Park Seung-Chol
Rim Joung-Sik
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Abstract
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Purpose: The median survival of hormone refractory prostatic cancer(HRPC) is generally less than 1 year from onset. This study aim to determine the safety and activity of paclitaxel in combination with estramustine and etoposide in patients with HRPC retrospectively.
Materials and Methods : From April 2003 to June 2005, 11 men with HRPC were treated with paclitaxel based chemotherapy. This regimen were oral estramustine 280mg tid and oral etoposide 25mg tid for 10 days, with paclitaxel 135mg/m2 IV over 1 hour on 2nd day of each 30 days treatment cycle. Patients received six cycles of this regimen. Patients were evaluated for response radiographically after 3 cycle(3 months) and then every 3 months. Serum prostate-specific antigen(PSA) level was determined every 3 months. Complete blood cell counts, biochemical profile and toxicity assessments were obtained every cycle.
Results: One patient was ineligible because he developed severe hematologic toxicity after chemotherapy. Median age was 72.1 years, median follow up was 9 months. Eight(80%) of the 10 patients had a ≥50% PSA decrease from baseline, 6(60%) achieved a ≥75% PSA level decrease. Of the 10 patients who completed the treatment, two reported partial response, two reported progressive disease, and six showed stabilization of disease in bone and lymph node. Major toxicities were grade 3 or 4 anemia in 10% of patients, neutropenia in 30%, thrombocytopenia in 30%.
Conclusions : Although hematological and gastrointestinal toxicity were modest, paclitaxel based combination chemotherapy provided biochemical and radiological response in HRPC. This combination regimen is an alternative therapeutic option in the treatment of HRPC. Long term follow up and larger randomized studies are warranted.
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KEYWORD
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Hormone, Prostate cancer, Paclitaxel
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