[A Case of Rapidly Progressive Metastatic Castration-Resistant Prostate Cancer : Durable Control by Early Induction of Carboplatin and Paclitaxel].
A 60-year-old man visited the previous hospital with difficulty of urination in July 2004. Serum prostate specific antigen (PSA) was 5.4 ng/ml and he was diagnosed with prostate adenocarcinoma, Gleason Score 4＋4＝8, cT1cN0M0. Although radical prostatectomy was recommended, he refused any treatment and never visited that hospital again. He was admitted to our hospital for exacerbation of dysuria with anal pain newly appeared in March 2005, when it was found that his disease had progressed to cT4N0M1b (thoracic spine, sacroiliac joint and ischium). Serum PSA decreased and the primary lesion shrunk after androgen deprivation therapy (ADT), whereas the left ischial lesion enlarged and serum carcinoembryonic antigen (CEA) and alkaline phosphatase (ALP) were elevated. For the castration-resistant progression, 30 Gy of local irradiation to the left ischial lesion and systemic chemotherapy with carboplatin (CBDCA) and paclitaxel (PTX) were administered, which led the patient to complete radiological and biochemical remission. The chemotherapy was discontinued in 2009 after the 18th course, and then ADT was also discontinued in 2010. The patient remains free from radiological or biochemical evidence of disease at the latest follow up in December 2014.
The Department of Urology, Kyoto University Hospital.
Takuro
T
Sunada
The Department of Urology, Kyoto University Hospital.
Takashi
T
Kobayashi
The Department of Urology, Kyoto University Hospital.
Noboru
N
Shibasaki
The Department of Urology, Kyoto University Hospital.
Yoshiyuki
Y
Okada
The Department of Urology, Kyoto University Hospital.
Hiromitsu
H
Negoro
The Department of Urology, Kyoto University Hospital.
Naoki
N
Terada
The Department of Urology, Kyoto University Hospital.
Toshinari
T
Yamasaki
The Department of Urology, Kyoto University Hospital.
Yoshiyuki
Y
Matsui
The Department of Urology, Kyoto University Hospital.
Takahiro
T
Inoue
The Department of Urology, Kyoto University Hospital.
Tomomi
T
Kamba
The Department of Urology, Kyoto University Hospital.
Osamu
O
Ogawa
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017239:Paclitaxel / Q000008:administration & dosage*; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D012074:Remission Induction
D016190:Carboplatin; D017239:Paclitaxel