https://scholars.lib.ntu.edu.tw/handle/123456789/544516
標題: | A pilot study of AFL-T (doxorubicin, 5-fluorouracil, leucovorin, and tamoxifen) combination chemotherapy for hormone-refractory prostate cancer | 作者: | CHIA-CHI LIN CHIH-HUNG HSU Chen J. Tsai T.-C. ANN-LII CHENG YEONG-SHIAU PU |
公開日期: | 2001 | 卷: | 21 | 期: | 2 B | 起(迄)頁: | 1385-1390 | 來源出版物: | Anticancer Research | 摘要: | Background: Tamoxifen had been used to treat advanced prostate cancer with limited success. In vitro data suggested that tamoxifen could enhance the cytotoxic effect of chemotherapeutic agents, including doxorubicin, on prostate cancer cell lines. We applied this observation into a phase II trial for patients with hormone refractory prostate cancer (HRPC). Patients and Methods: The AFL-T regimen consisted of doxorubicin 30 mg/m2/day on day 1; 5-FU 2,000 mg/m2/day 24-hour infusion and leucovorin 200 mg/m2/day 24-hour infusion on days 15 and 29; tamoxifen 50 mg/m2 four times daily on days 1, 2, 16, 17, 30, and 31. The protocol was designed to be of low dose-intensity and tolerable to most HRPC patients who may have reduced bone marrow reserve and poor renal function. Between Feb. 1994 and April 1999, 17 patients (median age 67, range 60-81) with HRPC were enrolled. Extensive hormonal manipulations had been done prior to the chemotherapy. Three patients had measurable diseases, 14 had only bone metastases, and all had elevated PSA levels (median 498 ng/ml, range 7.4 - 3,970 ng/ml). Results: All 17 patients were eligible for analysis of toxicity. ECOG Grade III/IV leukopenia and thrombocytopenia occurred in 1 and 3 patients, respectively. There was no febrile neutropenia; there was no treatment-related mortality. Grade III/IV nausea, vomiting, mucositis, and diarrhea were noted in 0, 0, 1 and 0 patient, respectively. There was no venous thrombosis. One partial response, 1 stable disease, and 1 progressive disease were found in the three patients with measurable lesions. Eleven of the 17 patients (64.7%, 95% confidence interval: 41-88%) who were eligible for the evaluation of PSA response (PSA decrease > 50% for at least 6 weeks) were responders. The median overall and progression-free survivals were 13 and 7 months, respectively. Seventy-six percent of patients showed decreased analgesic usage or enhanced performance status. Conclusion: AFL-T, that has a low toxicity profile, is comparable to most other active regimens in terms of the PSA response rate. Randomized trials are needed to determine if there exists a survival benefit for patients with HRPC. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0035021709&partnerID=40&md5=ae1bbf47c9e595c9c1d54387ca50934d https://scholars.lib.ntu.edu.tw/handle/123456789/544516 |
ISSN: | 0250-7005 | SDG/關鍵字: | doxorubicin; fluorouracil; folinic acid; prostate specific antigen; tamoxifen; adult; aged; article; bone metastasis; cancer chemotherapy; cancer hormone therapy; cancer survival; clinical article; clinical trial; cytotoxicity; diarrhea; drug tolerability; human; kidney function; leukopenia; male; mucosa inflammation; nausea; phase 2 clinical trial; priority journal; prostate cancer; thrombocytopenia; treatment outcome; vein thrombosis; vomiting; Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Doxorubicin; Fluorouracil; Follow-Up Studies; Humans; Leucovorin; Male; Middle Aged; Pilot Projects; Prostate-Specific Antigen; Prostatic Neoplasms; Survival Rate; Tamoxifen; Treatment Failure; Treatment Outcome |
顯示於: | 醫學系 |
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