Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Estramustine”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMed1989

[Prostate-specific antigen (PSA): diagnostic and prognostic implications in the evaluation of carcinoma of the prostate].

Prostatic specific antigen (PSA), glycoprotein with molecular weight of 34000, was first identified by Wang and Coll. in prostatic tissue initially; then Papsidero and Wang purified PSA in the sera of patients with prostatic cancer. We determined PSA concentration in 132 serum samples obtained from 111 patients affected by prostatic carcinoma: of these 61 had untreated prostatic cancer (6 had a stage A disease, 10 stage B, 19 stage C and 26 stage D) and 50 were variously treated (17 with cyproterone acetate, 11 with estramustine phosphate, 10 with LH-RH analogues, 9 underwent radical prostatectomy and 3 radiation therapy alone). Each patients was assigned a histological grade according to Gaeta, by means of a perineal transrectally guided prostatic biopsy. At periodical follow-ups of treated subjects, patients' state and neoplastic evolution were considered. Serum PSA has been measured by a competitive radioimmunoassay (PSA-Double antibody, Diagnostic Product Corporation) in which 125-I-labeled PSA competes with PSA in the samples for antibody sites. The antibody-bound fraction is then precipitated and counted. Since manipulation of the prostate gland may lead to elevated PSA levels, patients' samples were obtained prior to rectal examination, biopsy or surgical procedures. On the basis of a preliminary study of samples from healthy blood donors, we fixed the cut-off value at 2.9 ng/ml. In patients with untreated prostatic carcinoma PSA serum mean value was 26.33 ng/ml (range 0.5-100), resulting elevated in 56/61 (90,16%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Neoplasm↗
PubMed1989

[Remarkable pain relief in the treatment with high-dose medroxyprogesterone acetate in advanced prostatic carcinoma].

A 60-year-old man was admitted to our hospital because of lumbago due to a metastatic bone tumor that originated from the prostate. Previously, he had been treated with 500 mg/kg of diethylstilbestrol diphosphate and 75 mg/day of chlormadinone acetate. At our hospital, he was given 470.1 mg/day of estramustine sodium phosphate and a bilateral orchiectomy was performed. However, he felt increased lumbago. Thus, a dose of 1200 mg/day of medroxyprogesterone acetate was started. Although the histology of his prostate and bone scintigram did not change, the patient no longer felt lumbago from about 2 weeks after the start of this treatment. Six months later, he remains free of lumbago. In this report, we describe the effect of high-dose medroxyprogesterone acetate on the clinical course, and the plasma and urine levels of the hormones.

Adrenocorticotropic Hormone↗
PubMed1989

Treatment of prostate cancer.

The epidemiology, histopathology, diagnosis and staging, and treatment of prostate cancer are reviewed. Prostate cancer, one of the most common malignancies occurring in men over age 50, will strike an estimated 103,000 men in the United States in 1989. More than 95% of prostatic tumors are adenocarcinomas. Tumors are graded on the basis of their degree of differentiation. Most afflicted men initially complain of difficulty in starting the urinary stream and of urinary bleeding, dribbling, and retention. Urinary obstruction may be present in advanced disease, and anemia, anorexia, and bone pain are common in metastatic disease. Prostatectomy and irradiation are used to treat disease localized to the prostate; the prognosis for such patients is good. Survival is diminished in cases of locally advanced and metastatic disease. Symptomatic metastatic disease is treated by hormonal manipulation through orchiectomy and administration of exogenous estrogens (diethylstilbestrol), luteinizing hormone-releasing hormone analogs (leuprolide and goserelin), and antiandrogens (cyproterone acetate, flutamide, and others). Some 70-80% of patients respond to hormonal therapy for periods of up to three years. After relapse occurs, salvage hormonal therapies (aminoglutethimide and ketoconazole) may be attempted to prolong survival. Fluorouracil, doxorubicin, mitomycin, cisplatin, cyclophosphamide, methotrexate, and estramustine have also been administered, with mixed results. Once relapse occurs in prostate cancer patients after initial hormonal therapy, the response to salvage hormonal or cytotoxic therapy is minimal; in the future, total androgen blockade and methods of decreasing drug resistance may be used to prolong survival.

Humans↗
PubMed1989

[Clinical study on prostatic cancer patients].

Clinical observations on prostatic cancer were studied in 27 patients who had been managed in our department between April, 1980 and December, 1986. The mean age at the time of initial clinical visit was 70.6 years old with a range of 55 to 88 years old. Of all 27 patients, 15 men (55.6%) were senior citizens over 70 years old and indeed 23 men (85.2%) were over 60 years old. According to the general rules for clinical and pathological studies on prostatic cancer, there were 10 patients with stage A, 2 patients with stage B, and 15 patients with stage D disease. However, none of our patients had stage C foci of prostatic cancer. Histopathologically, biopsied or surgically resected specimen all showed adenocarcinoma. More frequently the incidence of poorly differentiated adenocarcinoma was found in the specimen from the patients with advanced clinical disease. Anti-androgen therapy with castration or a combined hormonal manipulation initially was done in 25 patients. Simple hormonal treatment using chlormadinone acetate (CMA) was given in 13 patients. Of 25 patients who received hormone treatment, 22 underwent castration whereas, 12 of 13 having undergone single hormonal therapy were castrated. Combined chemohormonal therapy using UFT and CMA or additionally given estramustine phosphate disodium (Estracyt) was subjected only to stage D disease of prostatic cancer. Of 15 patients surgically treated, 11 received transurethral resection of the prostate on the basis of initial diagnosis of benign prostate hypertrophy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1988

Results of a Dutch trial with the LHRH agonist buserelin in patients with metastatic prostatic cancer and results of EORTC studies in prostatic cancer.

Superactive analogues of luteinizing hormone-releasing hormone (LHRH) have now widely been used in the management of metastatic prostate cancer. In a multicentric study, we have studied the effectiveness of buserelin in patients with previously untreated histologically confirmed metastatic prostate cancer. Fifty-eight patients were enrolled in the study and are now followed for at least 12 months. The treatment consisted of 500 micrograms buserelin administered subcutaneously (s.c.) 3 times daily for the first seven days and thereafter a thrice-daily dose of 400 micrograms buserelin administered intranasally (i.n.). A continuous reduction of testosterone to castrate levels could be obtained in all patients. The following objective responses were seen during the 12 months study period: 5 patients (8.6%) achieved complete regression after 3-10 months (mean 6.4 m); 24 patients (41.4%) achieved partial regression after 1-12 months (mean 4.5 m); 7 patients (12%) remained stable throughout the study; 22 patients (32.3%) developed progression after 2-12 months (mean 7.2 m). Toxicity was minimal. Only one patient dropped out of the study because of side effects. These results are comparable with results of other forms of hormonal treatment of prostate cancer. Long-term results of 3 EORTC GU group comparative studies in metastatic prostate cancer are now available. The first study, 30761, compared cyproterone acetate, medroxy-progesterone acetate, and DES. No differences between the 3 treatment arms were observed except for medroxy-progesterone acetate, which showed less therapeutic effect in the dosage used. Protocol 30762 compared DES and estramustine phosphate. No significant difference in objective response and survival was noted. Protocol 30805 studied a comparison between orchiectomy alone and orchiectomy supplemented by cyproterone acetate and DES. Again no statistically significant difference was found between the three therapeutic arms.

Aged↗
PubMed1986

Report of two cases of male breast cancer after prolonged estrogen treatment for prostatic carcinoma.

Reviewing our experience with 19 cases of male breast cancer, we found two patients with a 12-year history of estrogen therapy for prostatic carcinoma. One initially received diethylstilbene followed by estradiol, 80 mg monthly, and finally estramustin, 140 mg twice daily. The other patient had dienestrol, 2.5 mg daily, and later estradiol, 40 mg every 6 weeks. The possible causal relationship between prolonged estrogen administration and breast cancer in males is in contrast to available epidemiologic data. Therefore, the possibility of an association by chance cannot be ruled out.

Aged↗
PubMed1988

[A case of carcinoma of the prostate presenting as abdominal mass].

A 69-year-old man was hospitalized for bilateral abdominal masses and constipation on October 31, 1986. Physical examination revealed firm, rough, movable, hard masses of over fist size, in the bilateral lower abdomen. CT scan disclosed two large masses in the pelvis. The prostate was of walnut size, rough and elastic firm on rectal examination. The serum acid phosphatase was elevated. Needle biopsy of the prostate and open biopsy of the mass showed a poor differentiated adenocarcinoma. Treatment with diethylstilbestrol diphosphate, 5-fluorouracil, estramustine sodium phosphate, chlormadinone acetate, 1-la-tetrahydrofuryl-5-fluorouracil, and cyclophosphamide was effective. The masses-metastasis of intrapelvic lymph nodes have shrunk and serum acid phosphatase has fallen to the normal level. In April 1987, the patient left hospital, and as of October 1987, he is still alive. This case indicates the presence of an unusual type of prostatic carcinoma in which huge lymph node metastasis occurs.

Adenocarcinoma↗
PubMed1987

Current status of endocrine therapy for prostate cancer.

Hormonal therapy, considered standard treatment for prostate cancer for forty years, is being reevaluated in light of more recent analysis of the studies conducted by the VA Cooperative Urologic Research Group (VACURG). Modalities reviewed include diethylstilbestrol, estramustine phosphate, aminoglutethimide, progestational agents, antiandrogens, orchiectomy, and the newer LHRH analogues, such as leuprolide and combination hormonal therapies. The author examines the rational use of hormonal treatments in terms of their advantages and disadvantages, the optimal timing and dosage of each, and the possibility of combining hormonal therapy with chemotherapy.

Hormones↗
PubMed1987

[Advanced prostate cancer--a therapeutic dilemma?].

The number of approaches available for the management of metastasizing prostatic carcinoma is overwhelming. If due attention is paid to prognostic factors, however, patients can be effectively treated in the urological practice. Once the condition has been diagnosed the first-line treatment carried out should be orchiectomy. Adjuvant drug therapies with such agents as progestogens and estrogens seem to be of little value. Data are not yet available from prospective studies performed to assess the value of complete androgen blockade. In addition, there is so far only experimental evidence that the effect of endocrine therapy is enhanced by an initial adjuvant chemotherapy in untreated prostatic carcinoma, and this should be investigated in randomized clinical trials. In the case of tumor progression estrogens or antiandrogens can be administered to relieve the symptoms; good effects have been achieved especially with estramustine phosphate. Further progression demands chemotherapy, which should be selected with reference to Berry's parameters. There is no agent or combination generally accepted as the chemotherapeutic agent of choice.

Antineoplastic Agents↗
PubMed1987

[A case of giant carcinoma of the prostate].

A 74-year-old male complaining of lower abdominal mass was admitted to our hospital on August 1, 1985. He had also suffered from dysuria and bilateral lower limb edema for a year. At the time of admission, two fist-size hard masses were palpable on each suprainguinal abdomen. Remarkable venous dilatation on the surface of the whole abdomen was recognized. An enlarged stone-like hard prostate was palpable by rectal examination. Laboratory findings revealed moderately increased blood sedimentation rate and a high value of prostatic acid phosphatase. Urethrocystogram showed remarkable compression of both lateral walls of the bladder medially and the floor of the bladder was highly elevated. Computed tomography revealed almost the whole pelvic cavity occupied by the tumor which had invaded the retroperitoneal space upward as far as the level of the hilus of the kidney. Histological diagnosis was well-differentiated adenocarcinoma of prostate. Bilateral orchiectomy was performed on August 29, 1985 and he was treated with estramustine phosphate (Estracyt) 560 mg a day. Two months later, there was remarkable regression of the tumor and urethrocystogram was almost normal. Related reports are also reviewed.

Adenocarcinoma↗
PubMed1983

[1st clinical results of the treatment of locally advanced prostatic cancer with a powerful LH-RH analog: buserelin acetate].

From a series of 39 patients presenting with a locally advanced cancer of the prostate (Stage C), 26 were treated with an LH-RH analogue, Buserelin, for a period ranging between 7 and 22 months. After an initial period of subcutaneous injections, the treatment was administered by intranasal spray (400 mcg three times a day). This resulted in levels of testosterone similar to those of castrated men. In order to evaluate the effects of buserelin on the primary tumour, a degree of cytological regression was established for all of the patients, using fine-needle aspiration biopsy which was performed every three months. The cytological results correspond with the DNA analyses performed by cytophotometry of isolated cells and reveal a statistically significant reduction in the degree of anaploidy or polyploidy in the cases in which the prostatic cancer had responded favourably to treatment with buserelin. 21 of the 26 patients treated with this potent LH-RH analogue showed a good therapeutic response. 5 patients who did not show any signs of cytological regression were secondarily treated with estramustine phosphate because of their resistance to hormones. One patient received cyclophosphamide as a tertiary treatment because of progression of his symptoms after 15 months. No appreciable side effects were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Microtubules and antineoplastic drugs].

Microtubules, which are composed of polymerized tubulin dimers, play an important role in various cell functions. For example, they maintain cell shape, form mitotic spindles in M phase of cell cycle, and carry an axonal transport in nerve cells. Microtubules have also been an important target of cancer chemotherapy. Vinca alkaloids depolymerize microtubules, the mechanisms of which action have extensively been investigated recently. Clinical trials of vinorelbine (navelbine), a new semisynthetic vinca alkaloid, are ongoing in Japan. One of advantages of the drug is reduced risk of neurotoxicity. Estramustine may act on microtubule-associated proteins (MAPs) as well as tubulin. It shows additive or synergistic cytotoxicity preclinically when used in combination with vinblastine. This combination was active against hormone-refractory prostate cancer. Another novel drug rhizoxin, which has a similar mechanism of action to that of vinca alkaloids, is also a promising cytotoxic agent and is examined clinically in Europe. Taxanes, which include paclitaxel (Taxol) and taxotere, are interesting drugs because they promote polymerization of tubulin and stabilize microtubules. They show promising antitumor activity against breast, ovarian and lung cancers. Phase I and II trials are ongoing in Japan. Paclitaxel may also potentiate cytotoxicity of radiation. There are several mechanisms of resistance to microtubule-acting drugs. One is multidrug resistance mediated by P-glycoprotein. Other mechanisms include mutation of tubulin.

Animals↗
PubMed1994

[Medical treatment of prostate cancer].

Hormone dependence of prostate cancer is well known. In 80% of cases with metastases, hormone suppression leads to the reduction of tumour volume and related disorders. However the treatment is generally palliative because malignant process recurs after about around 16 months. Mean survival is less than 3 years in these forms. Lack of response come always together with a poor prognosis, and there is 90% mortality at 2 years. Advanced prostatic cancer should not be treated with hormones if the patient has few symptoms and his quality of life is satisfactory. Symptomatic forms require hormone manipulation. Orchidectomy or LH-RH are recommended. Total androgen ablation (combined treatment) leads rapidly to more relief of symptoms, but its drawbacks and especially high cost indicate that its use should be weighed individually. Estramustine is not a first-lune treatment. Presently, there is no criteria to predict response to treatment.

Androgen Antagonists↗
PubMed1993

[Clinical assessments on pre-treatment prognostic factors in 138 patients with advanced prostatic carcinoma (stage D2)].

We investigated the prognostic factors in 138 patients with stage D2 prostatic cancer by univariate and multivariate analyses. Analysis was restricted to 8 pre-treatment parameters, that is, age, general condition (PS), pain, number of metastases on bone scan, acid phosphatase value, Gleason's primary pattern, secondary pattern, and nucleoli grading. In addition, 4 therapeutic modalities except routine endocrine therapy, that is, castration, oral administration of estramustine phosphate, of 5-fluorouracil (5-FU) or its analogue, and combination chemotherapy, during the whole treatment period were included in the analysis. Univariate analysis (Kaplan-Meier method) showed only PS to be a significant prognostic factor. Multivariate analysis (Cox's proportional hazard model) revealed that PS, Gleason's primary pattern, oral administration of 5-FU or its analogue and combination chemotherapy were significant prognostic factors. However, patients treated by combination chemotherapy had poorer prognosis and chi 2 values of combination chemotherapy was the highest among the four parameters cited above. These results suggested that the 8 pre-treatment parameters examined in this study were not sufficient for predicting the prognosis of each patient.

Acid Phosphatase↗
PubMed1993

Treatment of progressive metastatic prostate cancer.

The optimal therapy for metastatic prostate cancer that has failed initial hormonal therapy poses a significant dilemma for the attending physician. No salvage therapy has proven to be clearly superior. Currently accepted treatment options range from supportive care alone to highly investigational regimens. Recent encouraging results have been reported with investigational agents such as suramin and R. 75251 (Liarozole), and with novel combinations such as estramustine (Emcyt) plus vinblastine. However, there is still no proof that salvage therapy prolongs survival. In a patient population that is older and frequently debilitated, with an expected median survival of 6 months, determinants of therapy should include drug toxicity profiles, frequency of treatment and follow-up studies, and necessity for hospitalization. For patients with good performance status and organ function, participation in clinical trials should be advocated. Quality-of-life issues should be integrated into all clinical trials involving hormone-refractory metastatic prostate cancer.

Androgen Antagonists↗
PubMed1996

Potentiation of radiation therapy by vinorelbine (Navelbine) in non-small cell lung cancer.

Vinorelbine (Navelbine; Burroughs Wellcome Co, Research Triangle Park, NC; Pierre Fabre Medicament, Paris, France), a semisynthetic vinca alkaloid that is a potent inhibitor of mitotic microtubule polymerization, was recently approved for the treatment of non-small cell lung cancer. Radiotherapy also has been widely used to treat this malignancy. Since other antitumor agents that act on microtubules, such as paclitaxel and estramustine, have been shown to act as radiosensitizers, we studied the ability of vinorelbine to potentiate radiation. The in vitro activity of this combination was evaluated in the human lung carcinoma cell lines NCI-H460 and A549. when NCI-H460 cells were exposed to vinorelbine for 24 hours and then irradiated (1 to 6 Gy) the drug potentiated radiation in a dose-dependent manner, with the ratio of fractional survival (radiation) to fractional survival (drug plus radiation) ranging from 1.7:1 at 1 Gy to 5.5:1 at 6 Gy. When the treatment sequence was reversed (ie, radiation was followed by drug exposure), similar survival ratios were obtained at concentrations of vinorelbine that were five to 10 times lower. In this cell line radiation produced a block in the G2/M phase of the cell cycle, with the maximum block (60% to 70%) occurring 10 hours after treatment. The greatest potentiation was seen when irradiated cells were exposed to vinorelbine after they had plateaued in the G2/M phase of the cycle. Vinorelbine given early after irradiation, when only 10% to 30% of the cells were in G2/M, produced survival ratios similar to those of controls treated with radiation alone. In A549 cells radiation induced a G1 block. In this case, vinorelbine was unable to potentiate the effects of radiation. These studies show that vinorelbine can potentiate the antitumor effects of radiation and that the potentiation is cell cycle-dependent, with the maximal effect being obtained when the cells are in the G2 phase.

Carcinoma↗
PubMed1996

[Combination therapy with hormonal, radiation and chemotherapy for stage C prostate cancer].

To improve the effectiveness of treatment for patients with stage C prostate cancer, therapy in combination with hormonal, radiation and chemotherapy was given for the initial period, and there after, hormonal therapy was continuously administered to 18 patients with chemotherapy and three patients without it. At the Social Health Insurance Medical Center, between May 1988 and August 1991, 21 patients were diagnosed to have stage C histologically confirmed adenocarcinoma of the prostate. The average age of the patients was 69.0 years. The tumor was well, moderate and poorly differentiated in 5, 6 and 10 patients, respectively. As hormonal therapy, orchiectomy was performed on 19 of the 21 patients. Furthermore, 11 patients were administered estramustine phosphate, 9 chlormadinone acetate, and one diethylstilbestrol diphosphate. As, radiation therapy, all patients were treated with AP-PA parallel opposing technique to small pelvis with a 12 cm x 12 cm treatment field (44-45 Gy) combined with conformation radiotherapy to prostate (20-26 Gy). Chemotherapy was performed using either one or a combination of the following; cis-diamminedichloroplatinum, adriamycin, cyclophosphamide, 5-fluorouracil, methotrexate and etoposide. The observation period was 54.5 months on the average. Recurrence was observed in 3 patients, for all of which the sites were at bone. The 5-year non-recurrence rate was 90.4% by Kaplan-Meier's method. There were 4 deaths, three were due to prostate cancer and one to gastric cancer. The 5-year cumulative survival rate by Kaplan-Meier's method was 90.5%. In conclusion, this treatment was effective for stage C cases of prostate cancer.

Aged↗
PubMed1996

[The role of etoposide therapy in urogenital cancer].

Testicular cancer is recognized as a model of curable cancer by chemotherapy, and etoposide is the one of the most important drugs in its treatment. Etoposide has been used with cisplatin and bleomycin as a first-line combination chemotherapy since the early 1980s. It is now the key drug in the setting of high-dose chemotherapy for refractory cases. Oral, low-dose etoposide may provide effective palliation in some patients refractory to possible curative salvage therapy. Oral etoposide may also play a role in the maintenance therapy adjunctive to salvage therapy. Nevertheless, etoposide has failed to show definite therapeutic efficacy in the treatment of renal cell carcinoma and bladder cancer. The combination therapy of oral etoposide and estramustine, however, showed promising results for the treatment of hormone-refractory prostate cancer. Further investigations are required for this new treatment strategy for prostatic cancer.

Antineoplastic Agents, Phytogenic↗