Preliminary results of mitoxantrone and hydrocortisone in the treatment of hormone refractory prostate cancer
Article published in Urologia Polska 2002/55/3.

authors

Paweł Wiechno, Beata Paluchowska, Piotr Marczyński, Tomasz Demkow: Klinika Nowotworów Układu Moczowego Centrum Onkologii-Instytutu w Warszawie
Kierownik kliniki: dr hab. Tomasz Demkow

keywords

prostate, cancer, hormone refractory prostate cancer, chemotheraphy, mitoxantrone

summary

The aim of the study; We present preliminary results of mitoxantrone and hydrocortisone in the treatment of hormone refractory prostate cancer.

Material and method. Between March 15.2000 and August 30,2001, in the Clinic of Genitourinary Tract Neoplasms, 15 patients aged from 46 to 78 years (mean 65 years) with advanced hormone refractory prostate cancer and in good general status were qualified to the treatment with hydrocortisone (40 mg/day, orally) combined with mitoxantrone (12 mg/m2 intravenously, every 21 days). PSA levels before cytostatic treatment introduction were from 25 ng/ml to 3633 ng/ml (mean: 189 ng/ml). In 12 patients metastases to the skeleton were diagnosed; 3 of them had also soft tissue metastases. In 3 patients increase of the PSA level was a single sign of cancer progression. In 9 patients progression of the disease was associated with subjective symptoms and signs. Toxicity of the treatment, subjective and radiologic responses, PSA levels and time to cancer progression were estimated.

Results. Patients obtained from 3 to 9 cycles of (he treatment (mean 7 cycles); in totally 95 cycles. In 10 patients the cytostatic treatment was stopped due to cancer progression, in 3 patients is still being continued. Three patients died, \'lire most frequent adverse events were: thrombocytopenia, leukopenia and anaemia. Supraventricular arrhythmia or thrombophlebitis were rare. In 7 oI9 patients subjective improvement was noted. In 12 patients PSA level decreased; in 6 of them decreased levels were satisfied to partial response criteria. In 2 of 12 patients decrease of osseous metastases, and in 1 of 3 patients a decrease of soft tissue metastases was observed. Progression of the disease was noted from 9 to 27 weeks (mean 21 weeks) after the start of the therapy. Conclusions. In patients with hormone refractory prostate cancer and castration testosterone levels, the treatment with hydrocortisone and mitoxantrone is well tolerated, in about 40% of patients objective response is observed, and in majority of patients subjective improvement is noted.

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