{"title":"[一例去势抵抗性前列腺癌,在接受最佳支持治疗后病情完全好转]。","authors":"H. Kise","doi":"10.5980/jpnjurol.112.113","DOIUrl":null,"url":null,"abstract":"The patient was a 78-year-old man who, at 67 years of age, had been diagnosed with prostate cancer cT3bN1M0 (Gleason score 5+5) and started on androgen ablation therapy. Thereafter, the cancer had developed into castration-resistant prostate cancer; thus, after surgical castration, the patient was treated with 27 courses of docetaxel, as well as enzalutamide and abiraterone. However, new metastases appeared in the paraaortic lymph nodes, post which, the patient was treated with 25 courses of cabazitaxel. However, the paraaortic and intrapelvic lymph nodes became enlarged, the patient developed rectal occlusion and urinary retention due to growth of the primary tumor, and his general condition deteriorated. Hence, the patient decided to abandon treatment approximately 10 years after initial diagnosis, underwent cystostomy, and transitioned to best supportive care. After stopping treatment, his general condition started to improve, and approximately 6 months later, his PSA levels had fallen from 55.5 ng/mL to 19.3 ng/mL and the lymph nodes had also reduced in size. When the cancer was treated with local radiation, the enlarged tumor disappeared, and the patient was able to urinate again. It has now been 2.5 years since treatment was stopped, and both, the paraaortic and intrapelvic lymph nodes have reduced in size to < 1 cm, and the PSA value continues to remain less than 0.008 ng/ml.","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"13 1","pages":"113-116"},"PeriodicalIF":0.0000,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[A CASE OF CASTRATION-RESISTANT PROSTATE CANCER THAT COMPLETELY AMELIORATED AFTER TRANSITION TO BEST SUPPORTIVE CARE].\",\"authors\":\"H. Kise\",\"doi\":\"10.5980/jpnjurol.112.113\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The patient was a 78-year-old man who, at 67 years of age, had been diagnosed with prostate cancer cT3bN1M0 (Gleason score 5+5) and started on androgen ablation therapy. Thereafter, the cancer had developed into castration-resistant prostate cancer; thus, after surgical castration, the patient was treated with 27 courses of docetaxel, as well as enzalutamide and abiraterone. However, new metastases appeared in the paraaortic lymph nodes, post which, the patient was treated with 25 courses of cabazitaxel. However, the paraaortic and intrapelvic lymph nodes became enlarged, the patient developed rectal occlusion and urinary retention due to growth of the primary tumor, and his general condition deteriorated. Hence, the patient decided to abandon treatment approximately 10 years after initial diagnosis, underwent cystostomy, and transitioned to best supportive care. After stopping treatment, his general condition started to improve, and approximately 6 months later, his PSA levels had fallen from 55.5 ng/mL to 19.3 ng/mL and the lymph nodes had also reduced in size. When the cancer was treated with local radiation, the enlarged tumor disappeared, and the patient was able to urinate again. It has now been 2.5 years since treatment was stopped, and both, the paraaortic and intrapelvic lymph nodes have reduced in size to < 1 cm, and the PSA value continues to remain less than 0.008 ng/ml.\",\"PeriodicalId\":38850,\"journal\":{\"name\":\"Japanese Journal of Urology\",\"volume\":\"13 1\",\"pages\":\"113-116\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-04-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Japanese Journal of Urology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5980/jpnjurol.112.113\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Japanese Journal of Urology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5980/jpnjurol.112.113","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
患者是一名78岁的男性,67岁时被诊断为前列腺癌cT3bN1M0 (Gleason评分5+5),并开始接受雄激素消融治疗。此后,癌症发展为去势抵抗性前列腺癌;因此,在手术阉割后,患者接受了27个疗程的多西他赛,以及恩杂鲁胺和阿比特龙的治疗。然而,在主动脉旁淋巴结出现新的转移,之后,患者接受了25个疗程的卡巴他赛治疗。然而,主动脉旁和盆腔内淋巴结肿大,患者因原发肿瘤的生长而出现直肠闭塞和尿潴留,一般情况恶化。因此,患者在最初诊断后大约10年决定放弃治疗,接受膀胱造口术,并过渡到最佳支持治疗。停止治疗后,患者的一般情况开始好转,大约6个月后,PSA水平从55.5 ng/mL降至19.3 ng/mL,淋巴结也缩小了。当肿瘤接受局部放射治疗时,增大的肿瘤消失了,病人又能排尿了。停止治疗至今已2.5年,主动脉旁淋巴结和盆腔内淋巴结均缩小至< 1 cm, PSA值继续低于0.008 ng/ml。
[A CASE OF CASTRATION-RESISTANT PROSTATE CANCER THAT COMPLETELY AMELIORATED AFTER TRANSITION TO BEST SUPPORTIVE CARE].
The patient was a 78-year-old man who, at 67 years of age, had been diagnosed with prostate cancer cT3bN1M0 (Gleason score 5+5) and started on androgen ablation therapy. Thereafter, the cancer had developed into castration-resistant prostate cancer; thus, after surgical castration, the patient was treated with 27 courses of docetaxel, as well as enzalutamide and abiraterone. However, new metastases appeared in the paraaortic lymph nodes, post which, the patient was treated with 25 courses of cabazitaxel. However, the paraaortic and intrapelvic lymph nodes became enlarged, the patient developed rectal occlusion and urinary retention due to growth of the primary tumor, and his general condition deteriorated. Hence, the patient decided to abandon treatment approximately 10 years after initial diagnosis, underwent cystostomy, and transitioned to best supportive care. After stopping treatment, his general condition started to improve, and approximately 6 months later, his PSA levels had fallen from 55.5 ng/mL to 19.3 ng/mL and the lymph nodes had also reduced in size. When the cancer was treated with local radiation, the enlarged tumor disappeared, and the patient was able to urinate again. It has now been 2.5 years since treatment was stopped, and both, the paraaortic and intrapelvic lymph nodes have reduced in size to < 1 cm, and the PSA value continues to remain less than 0.008 ng/ml.