Background & objective: Effective treatment for hormone refractory prostate cancer was required. This study was to evaluate efficacy of combined chemotherapy of gemcitabine and cisplatin on hormone refractory prostate cancer, and its toxicities.
Methods: Fifteen patients with advanced hormone refractory prostate cancer,who received castration and antiandrogen medicines,were conformed multiple bone metastatic carcinomas by emission computed tomography (ECT). One patient had hepatic metastasis, 1 had adrenal metastasis, and 1 had intracranial metastasis. The value of prostate special antigen (PSA) was in an ascending trend in all patients. Gemcitabine of 1 000 mg/m(2) and normal saline solution (NS) of 100 ml were administered by intravenous drip on day 1, and day 8, cisplatin of 100 mg/m(2) and NS of 500 ml were administered by intravenous drip on day 1, or cisplatin of 30 mg/m(2) and NS of 250 ml were administered by intravenous drip from day 1 to day 5 within each 28-day cycle.
Results: Values of PSA in 10 patients descended to normal level (< 4 ng/L), those in 4 patients descended by more than 50%, and that in 1 patient had no change. Before chemotherapy, 12 patients suffered from pain of bone metastasis with 4 cases of grade I, 5 cases of grade II, and 3 cases of grade III. After chemotherapy, 9 patients released from pain,only 2 suffered from pain of grade I, 1 suffered from pain of grade II. The maximal diameter of multiple intracranial metastatic lesions was reduced from 3.0 to 0.5 cm, and the symptoms of facial paralysis vanished. Diameter of hepatic metastatic tumor was reduced from 10.2 to 3.3 cm, that of adrenal metastatic tumor was reduced by more than 2/3. Patients were followed-up for 3-29 months with a mean of 15.2 months. Of 15 patients, 2 died of the disease,the median survival time was 14.7 months. Mean time of pain remission was 13.6 months, and the stable period of PSA value descent was 12.3 months. Toxicities of chemotherapy were tolerable, including nausea/vomiting,leukopenia,decreased hemoglobin,and thrombo- cytopenia.
Conclusions: Combined chemotherapy of gemcitabine and cisplatin is effective in treating advanced hormone refractory prostate cancer with tolerable toxicities, and could be considered as an adjuvant therapy for advanced hormone refractory prostate cancer.