Oral combination of cyclophosphamide, uracil plus tegafur and estramustine for hormone-refractory prostate cancer.
OBJECTIVE
To evaluate the clinical usefulness of an oral combination of cyclophosphamide, uracil plus tegafur (UFT) and estramustine in the treatment of patients with hormone-refractory prostate cancer (HRPC).


METHODS
Twenty-one patients were treated with oral administration of cyclophosphamide (100 mg/day), UFT (400 mg/day) and estramustine phosphate (560 mg/day). The median age of the patients was 70 years. Twelve patients had symptomatic bone metastasis, 6 had asymptomatic bone metastasis, 5 had lymph node metastasis, while 2 had only biochemical progression evaluated by prostate-specific antigen (PSA).


RESULTS
Twelve (57%) out of 21 patients showed a PSA decline of 50% or greater. The median response duration was 7 months (range 2-15 months). Among the 20 patients assessable for bone pain, 2 (10%) improved, 12 (60%) remained stable and 6 (30%) progressed. Among the 10 patients assessable for bone metastasis, 1 (10%) improved, 5 (50%) were stable and 4 (40%) progressed on bone scan. Among 3 patients assessable for measurable disease (lymph node metastasis), 2 (67%) showed partial response and 1 (33%) progression. Most toxicities were mild.


CONCLUSIONS
The combination of cyclophosphamide, UFT and estramustine is an active and well-tolerated regimen for HRPC. To evaluate the survival benefit, further randomized studies are required.
Nishimura
K
K
Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan. kazu@uro.med.osaka-u.ac.jp
Nonomura
N
N
Ono
Y
Y
Nozawa
M
M
Fukui
T
T
Harada
Y
Y
Imazu
T
T
Takaha
N
N
Sugao
H
H
Miki
T
T
Okuyama
A
A
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000556:secondary; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004961:Estramustine / Q000008:administration & dosage*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D005641:Tegafur / Q000008:administration & dosage*; D016896:Treatment Outcome; D014498:Uracil / Q000008:administration & dosage*; D014554:Urination
D000726:Androgen Antagonists; D000964:Antimetabolites, Antineoplastic; D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D005641:Tegafur; D004961:Estramustine; D014498:Uracil; D003520:Cyclophosphamide; D017430:Prostate-Specific Antigen