病例系列報告: 嚴重初診斷轉移性攝護腺癌合併使用男性荷爾蒙去除治療合併化學治療的高雄榮民總醫院經驗

何明錫、林仁泰、吳東霖、余家政、陳逸軒

高雄榮民總醫院 外科部 泌尿外科

The experience of upfront chemotherapy for high volume metastatic hormone-sensitivity prostate cancer (mHSPC) of Kaohsiung Veterans General Hospital

Ming-Xi He, Jen-Tai Lin, Dong-lin Wu, Chia-Cheng Yu, I-Hsuan Chen,

Divisions of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

Purpose:

Androgen-deprivation therapy (ADT) has been the standard of care for advanced prostate cancer since the 1940s. According to the CHAARTED trial, upfront chemotherapy improved overall survival and time to progression in high volume metastatic hormone-sensitivity prostate cancer (mHSPC). We present our experience about upfront chemotherapy for high volume mHSPC.

Materials and Methods:

We has 14 men with high volume metastatic, hormone-sensitive prostate cancer to receive upfront docetaxel chemotherapy within the first 3 months of ADT.

Results:

A total of 14 patient were received combination therapy. (Median age 71.5, range from 48- to 83-year-old; Medina iPSA 424.4 ng/ml, range from 15.71 to 2293; one patient has Gleason 7, one has Gleason 8, eight have Gleason 9 and three have Gleason 10; Three patients have visceral meatstasis). Seven patients had biochemical progression (the median time 9 months; and range: from 2 months to 18 months). Fifty percent (7/14) of the patient had their nadir PSA level less than 1 ng per milliliter after upfront chemotherapy.

Conclusion:

  The upfront chemotherapy combining with ADT was well tolerable and seemed to augment the tumor control in high risk mHSPC.