[Chemotherapy of hormone-unresponsive prostatic cancer and its metastatic foci]

This article is a review of the results of chemotherapy for advanced hormonally-unresponsive prostatic carcinoma. Although the only hope for treatment of these patients is chemotherapy, until recently relatively little emphasis has been placed on chemotherapy of prostatic cancer. Since results of the randomized trial of the National Prostatic Cancer Project in the United States revealed a demonstrable advantage of advanced hormonally-refractory disease, a number of studies has been done and reported. As single chemotherapeutic agent, cyclophosphamide (CPM), 5-fluorouracil (5-FU), Adriamycin (ADM), and Cisplatinum (CDDP) have activity in these patients. Estracyt has been reported very effective, but has been somewhat disappointing in American trials. Several combination chemotherapies have been reported effective, such as CPM + ADM, CPM + ADM + Methotrexate (MTX), and CPM + MTX + 5-FU + Vincristine, Prednisone. Presently, however, there is no evidence that combination chemotherapy in prostatic cancer is better than single-agent chemotherapy. The need for continued effort to search powerful new agent, and to establish more effective combination chemotherapy for prostatic cancer should be emphasized. Furthermore, the importance of randomized and stratified clinical trials, early and late in the course of the disease, is stressed.