臨床泌尿器科60巻1号

2006年01月発行

症例

二次内分泌療法開始後にDICを伴う重篤な病勢進行をきたした再燃性前立腺癌

著者： 根本勺¹ 清水宏之² 西村泰司²

所属機関： ¹北村山公立病院泌尿器科 ²日本医科大学付属病院泌尿器科

ページ範囲：P.61 - P.63

文献概要

77歳，男性。臨床病期D2の前立腺癌にて除睾術が施行されている。今回，再燃をきたし二次内分泌療法としてCAB療法を施行。治療開始13日後より，DICおよび神経症状を併発した骨痛の増強を認めた。臨床経過より，二次内分泌療法が，急激な病勢進行に関与している可能性も考えられた。

参考文献

1）Thompson IM, Zeidman EJ and Rodriguez FR：Sudden death due to disease flare with luteinizing hormone-releasing hormone agonist therapy for carcinoma of the prostate. J Urol 144：1479-1480, 1990

2）Shimizu T, Shibata Y, Uchida T, et al：Severe flare-up in a prostate cancer patient treated with luteinizing hormone-releasing hormone analogue depot.泌尿紀要39：953-955，1993

3）Laufer M, Sinibaldi VJ, Carducci MA, et al：Rapid disease progression after administration of bicalutamide in patients with metastatic prostate cancer. Urology 54：745 1999

4）中川　克，辻　　肇：固形癌とDIC．医学のあゆみ206：43-47，2003

5）Lowe FC and Somers WJ：The use of ketoconazole in the emergency management of disseminated intravascular coagulation due to metastatic prostatic cancer. J Urol 137：1000-1002, 1987

6）Dondi D, Limonta P, Moretti RM, et al：Antiproliferative effects of luteinizing hormone-releasing hormone（LHRH）agonists on human androgen-independent prostate cancer cell line DU 145：evidence for an autocrine-inhibitory LHRH loop. Cancer Res 54：4091-4095, 1994

7）Damyanov C, Tzingilev B and Tabakov V：Treatment of an orchiectomized patient with hormone-refractory prostate cancer with LH-RH agonists. Eur Urol 40：474-476, 2001

8）Limonta P, Moretti RM, Marelli MM, et al：The luteinizing hormone-releasing hormone receptor in human prostate cancer cells：messenger ribonucleic acid expression, molecular size, and signal transduction pathway. Endocrinology 140：5250-5256, 1999

9）Marelli MM, Moretti RM, Dondi D, et al：Luteinizing hormone-releasing hormone agonists interfere with the mitogenic activity of the insulin-like growth factor system in androgen-independent prostate cancer cells. Endocrinology 140：329-334, 1999

10）Wells A, Souto JC, Solava J, et al：Luteinizing hormone-releasing hormone agonist limits DU-145 prostate cancer growth by attenuating epidermal growth factor receptor signaling. Clin Cancer Res 8：1251-1257, 2002

11）Bubley GJ：Is the flare phenomenon clinically significant? Urology 58：5-9, 2001