[The effectiveness of anal submucosal injection of methotrexate for relapsed prostatic cancer--a case report]

The case is a 77-year-old man who was first examined in August 1980 (at age 67). Prostatic biopsy revealed a poorly-differentiated adenocarcinoma, and clinically, diagnosis was made as stage B. Castration and DES administration were carried out. Subsequent chemotherapy with BLM, MMC, and 5-FU led to CR. A periodical check-up in September 1985 detected a pelvic lymph node metastasis, which was, however, completely remitted by radiotherapy and chemotherapy. In April 1990, local relapse was noted in the left lobe of the prostate. Biopsy revealed a poorly-differentiated adenocarcinoma. Three courses of intravenous administration of CDDP, THP, and VP-16 caused no change. From August 1990 on, anal submucosal injection of MTX was started. 20 mg of MTX administration once a week, for consecutive 5 weeks, followed by 4-week interruption on ambulatory basis formed one course. The tumor was distinctly reduced following one course, disappeared (MRI) following two courses and showed only a few viable cells (biopsy) following four courses. We consider that the present method is a hopeful new therapeutic approach.