RESUMEN
BACKGROUND: The aim of this study was to investigate the efficacy and toxicity of docetaxel-based chemotherapy, and to investigate pretreatment factors that can predict overall survival (OS) in patients with castration-resistant prostate cancer (CRPC). METHODS: From June 2005 to July 2010, 70 patients with CRPC underwent docetaxel-based chemotherapy at Wakayama Medical University and related hospitals. Docetaxel was given at a dose of 70 mg/m(2) once every 3 weeks or 35 mg/m(2) twice every 3 weeks. Oral estramustine 560 mg was given concurrently for five consecutive days during weeks 1 and 2 of each cycle, and prednisolone 10 mg was given every day. Dexamethasone 8 mg was premedicated intravenously before docetaxel administration. RESULT: The patients received a median of four cycles of treatment (range 1-31). In the serum prostate-specific antigen response, 13 (18.6%) patients achieved a complete response and 29 (41.4%) achieved a partial response. Median OS and time to progression were 14 months and 6 months, respectively. Median follow-up period was 9.5 months. Two independent pretreatment risk factors that predicted OS were visceral metastasis including lymph node metastasis and anemia. Grade 3/4 neutropenia and anemia occurred in 25.7 and 8.6% of the patients, respectively. Four treatment-related deaths were seen during the observation period. CONCLUSION: The combination of docetaxel, estramustine and prednisolone was effective in Japanese patients with CRPC; however, this combination therapy should be carefully indicated to elderly and/or poor performance status patients due to its toxicity. Visceral metastasis and anemia were identified as independent risk factors which could predict OS.
Asunto(s)
Estramustina/administración & dosificación , Metástasis Linfática/patología , Prednisolona/administración & dosificación , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico , Taxoides/administración & dosificación , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Docetaxel , Resistencia a Antineoplásicos/efectos de los fármacos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/mortalidad , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/patología , Estramustina/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Prednisolona/efectos adversos , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata Resistentes a la Castración/sangre , Neoplasias de la Próstata Resistentes a la Castración/mortalidad , Neoplasias de la Próstata Resistentes a la Castración/patología , Taxoides/efectos adversos , Resultado del TratamientoRESUMEN
We report a case of giant paraurethral leiomyoma weighing more than 100 g in a 19-year-old woman. She had been complaining of micturition pain and a mass at the external genitals. Magnetic resonance imaging showed a 5 cm mass surrounding the urethra, which appeared low intensity on T1-weighted images and higher intensity than that of the surrounding muscles in the pelvis on T2-weighted images. Biopsy was performed and the pathological diagnosis was leiomyoma. The mass was removed transvaginally and transperitoneally, which did not invade to urethra or vaginal wall. The resected specimen exhibited 8 x 7.5 x 3.6 cm in size and 105 g in weight. Pathological diagnosis was leiomyoma with no invasion to surrounding tissue. This is the 132nd case of female paraurethral leiomyoma in Japan, and there were only five cases (6%) of giant paraurethral leiomyoma weighing more than 100 g. We discuss the clinical and pathological features of this disease.