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Therapieoptionen beim hormonrefraktären Prostatakarzinom

Therapeutic options for hormone-refractory prostate cancer

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Zusammenfassung

Das hormonrefraktäre Prostatakarzinom galt lange Zeit als chemoresistenter Tumor. Durch die Einführung der Taxane hat sich diese Anschauung geändert. Die Therapie mit 75 mg/m2 Docetaxel 3-wöchentlich hat erstmals einen Überlebensvorteil in einer Phase-III-Studie gezeigt (18,9 Monate medianes Überleben gegen 16,5 Monate mit Mitoxantron). Weitere Vorteile waren eine bessere Schmerzreduktion und Lebensqualität. Bei den Nebenwirkungen stand die Neutropenie im Vordergrund. Docetaxel ist heute die Standardtherapie beim hormonrefraktären Prostatakarzinom.

Die Morbidität des metastasierten, hormonrefraktären Prostatakarzinoms wird durch die Knochenmetastasen geprägt. Schmerzen stehen im Vordergrund, Skelettkomplikationen sind häufig. Durch die Therapie mit Zoledronsäure 4 mg konnten die Skelettkomplikationen gegen Placebo signifikant reduziert werden. Am ausgeprägtesten ist die Reduktion für pathologische Frakturen. Nebenwirkungen umfassen grippeähnliche Symptome, Muskelschmerzen und Ödeme. Auch Zoledronsäure gehört zur Standardtherapie des knöchern metastasierten, hormonrefraktären Prostatakarzinoms.

Abstract

For a long time, hormone-refractory prostate cancer was regarded as a chemoresistant tumor. The introduction of taxanes has prompted a change in this opinion. For the first time treatment with 75 mg/m2 docetaxel every 3 weeks has evidenced a survival benefit in a phase III trial (median survival of 18.9 months versus 16.5 months with mitoxantrone). Further advantages were improved pain reduction and quality of life. Neutropenia was foremost among the side effects. Docetaxel is currently the standard treatment for hormone-refractory prostate cancer.

The morbidity of metastatic hormone-refractory prostate cancer is influenced by bone metastases. Pain is a prominent feature. Skeletal complications are frequent. Therapy with 4 mg zoledronic acid reduced skeletal complications significantly in comparison to placebo. The most pronounced effect is the reduction of pathological fractures. Side effects include flu-like symptoms, muscle pain, and edemas. Zoledronic acid also belongs to the standard treatment of hormone-refractory prostate cancer with bone metastases.

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Authors and Affiliations

  1. Urologische Klinik, Charité, Campus Benjamin Franklin, Universitätsmedizin, Hindenburgdamm 30, 12200, Berlin

    K. Miller

  2. Klinik und Poliklinik für Urologie, Universitätsklinikum, Essen

    C. Börgermann

  3. Urologische Klinik, Johannes-Gutenberg-Universität, Mainz

    J. Thüroff

  4. Urologische Klinik, Universität, Bonn

    P. Albers

  5. Klinik und Poliklinik für Urologie, Universitätsklinikum „Carl Gustav Carvus“, Technische Universität, Dresden

    M. Wirth

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  1. K. Miller
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  2. C. Börgermann
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  3. J. Thüroff
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  4. P. Albers
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  5. M. Wirth
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Correspondence to K. Miller.

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Miller, K., Börgermann, C., Thüroff, J. et al. Therapieoptionen beim hormonrefraktären Prostatakarzinom. Urologe 45, 580–585 (2006). https://doi.org/10.1007/s00120-006-1048-0

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  • DOI: https://doi.org/10.1007/s00120-006-1048-0

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