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1)再燃前立腺癌に対する従来の全身化学療法は対症療法の一つとして捉え, 他の治療法で改善が期待されない選択された症例にかぎるべきである。2) Suraminは副作用が強いが, 投与法の改善により効果が期待できる。3)広範な骨転移による症状を有する患者では, 疼痛の発現予防に, また鎮痛の目的で, 半身あるいは全身の小線量, 分割照射が有効なことがある。4) bisphosphonateは溶骨を抑制し, 骨新生を促進する。前立腺癌にも有効性が期待され, とくに放射線との併用は有効であろう, The treatment against hormone relapsing prostate cancer was examined clinically, experimentally and by a review of the literature. Conventional systemic chemotherapy should be appreciated as one of the symptomatic treatment options; and suramin might be an effective chemotherapeutic agent, if severe and the wide spectrum of side effects were concurred. Intermittent administration of suramin is beneficial at present, with monitoring of its concentration in the blood. Some patients with wide spread bone metastases, especially if they are symptomatic, would be the candidates for hemiskeletal irradiation. Low dose of fractionated radiation was found to be more effective than high dose of single radiation. Bisphosphonate was found to protect bone resorption and destruction from the inoculated prostatic cancer cells in nude mice. In the clinic, the compound would be effective to the aggravation of bone metastasis, especially in combined use with irradiation.

1)ヒト前立腺癌株PC-93を用いてin vitroならびにin vivoでsuraminの抗腫瘍効果とCDDPとの併用効果を検討した。2)in vitroではsuramin単独は臨床使用可能な濃度では十分な増殖抑制効果はえられなかった。その効果はcytostaticであった。3)CDDPとの併用では増殖抑制効果の延長と相加効果を認めた。4)suraminはEGFによるPC-93の細胞増殖促進効果を抑制した。5)ヌードマウスを用いた検討ではsuraminは持続的抗腫瘍効果を示し, CDDP併用により効果増強を認めた, The present study was designed to evaluate the antiproliferative effects of suramin and the combination of suramin plus cisplatin (CDDP) on the hormone-independent human prostate carcinoma cell line (PC-93). In vitro, suramin induced a dose-dependent reduction of PC-93 proliferation, and at the clinically achievable concentration (300 micrograms/ml), suramin induced a 19.7% decrease in proliferation on the 3rd day compared to suramin-free control (P < 0.01). However, from the 4th day on the inhibitory action of suramin was reversed following exposure. The suramin-cisplatin combination showed an additive effect (inhibition ratio 32.4% on the 3rd day), and prolongation of the inhibition activity on the 4th day on, but it did not show any synergistic effect. Suramin inhibited dose-dependently the growth stimulatory effect of exogenous epidermal growth factor (EGF). In vivo study, suramin and suramin-cisplatin combination showed antitumor effects continuously in nude mouse implanted PC-93. These findings suggest that the inhibitory effects of suramin on PC-93 are mediated by inhibition of the EGF-mediated growth mechanism, but by a cytostatic rather than cytotoxic manner in vitro. In addition, other mechanisms such as inhibition of angiogenesis factor might exist in vivo.