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    Korean J Urol. 2007 Jul;48(7):684-690. Korean.
    Published online Jul 31, 2007.
    https://doi.org/10.4111/kju.2007.48.7.684
    Copyright © 2007 The Korean Urological Association
    Original Article

    Estramustine Phosphate Based Chemotherapy for Hormone Refractory Prostate Cancer

    Kyung Seok Han, Kang Su Cho, Seung Hwan Lee and Sung Joon Hong
      • Department of Urology, Urologcial Science Institute, Yonsei University College of Medicine, Seoul, Korea.
    • Corresponding author (Email: sjhong346@yumc.yonsei.ac.kr )
    Received October 20, 2006; Accepted May 16, 2007.

    Abstract

    Purpose

    We wanted to evaluate the efficacy and side effects of estramustine monotherapy and estramustine plus etoposide or dexamethasone combined therapies for patients with hormone refractory prostate cancer (HRPC).

    Materials and Methods

    Between 2000 and 2004, 33 patients who were diagnosed with HRPC and treated with estramustine-based chemotherapy were evaluated. Eleven patients had oral estramustine monotherapy (group 1), 12 patients had oral estramustine plus oral etoposide (group 2), and finally 10 patients had oral estramustine plus oral dexamethasone (group 3). The prostate-specific antigen (PSA) response, progression-free survival and disease-specific survival were evaluated.

    Results

    The median patient age was 71 years and the median PSA was 97.3ng/ml. The median follow-up period was 17 months (range: 5-47). The overall response rate was 45.5%, and the response rate for each group was 36.4% for group 1, 41.7% for group 2 and 70.0% for group 3, respectively. The median time to progression (TTP) was 5 months (range: 1-16) overall and it was 5 months, 5.5 months and 5 months in groups 1, 2 and 3, respectively. Regarding the response rate, progression-free survival and disease specific survival, there were no statistically significant differences between the three groups (p>0.05). The most common hematologic complication was anemia that occurred in 28 patients and deep vein thrombosis occurred in 2. Severe toxicities (≥grade 3) occurred in only 2 patients.

    Conclusions

    Estramustine phosphate showed over a 45% response rates with less morbidities. Estramustine-based chemotherapy can be considered as an option for the treatment of HRPC. However, larger randomized controlled trials for regimens combined with other efficacious agents are necessary to elucidate the efficacy of chemotherapy for HRPC.

    Keywords
    Prostate cancer; Chemotherapy; Estramustine; Etoposide; Dexamethasone

    Figures

    Fig. 1
    Kaplan-Meier cumulative survival analyses according to the treatment groups. (A) Progression-free survival curves were not statistically different by the log rank test (p=0.734). (B) The disease-specific survival curves were not statistically different by the log rank test (p=0.686).

    Tables

    Table 1
    Patients' characteristics

    Table 2
    Prostate-specific antigen (PSA) response

    Table 3
    Overall toxicity of estramustine based chemotherapy

    Table 4
    Toxicity of estramustine based chemotherapy among the groups

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    MeSH Terms
    Anemia
    Dexamethasone
    Disease-Free Survival
    Drug Therapy*
    Estramustine*
    Etoposide
    Follow-Up Studies
    Humans
    Prostate*
    Prostatic Neoplasms*
    Venous Thrombosis
    Metrics
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