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AbstractBackground: The purpose of the present study was to evaluate the antitumor activity and toxicity of oral estramustine phosphate (EMP) in combination with oral etoposide in patients with hormone-refractory prostate cancer. Methods: Twenty patients with adenocarcinoma of the prostate that progressed after one or more regimens of androgen-deprivation therapy were enrolled into this trial. Oral EMP was administered twice daily, for a total daily dose of 560 mg, and oral etoposide (50 mg/bodyweight per day) was given on days 1–21 and was stopped on days 22–35. Treatment was continued until evidence of disease progression appeared or two consecutive rises in the prostate-specific antigen (PSA) value were observed. Results: Ten of 20 patients showed a decrease of 50% or greater in the PSA value from initially elevated PSA levels after therapy. The median progression-free duration and 2 year cause-specific survival rate of these 10 patients were 208 days (range 71–693 days) and 67.5%, respectively. There were no significant differences in age, pretreatment PSA value, duration from initial treatment to relapse, prior therapy or survival between patients who had a decrease of 50% or greater in PSA values after this combination therapy and those who did not. The main toxicities (≥ grade 2) were anemia, leukocytopenia, thrombocytopenia, gastrointestinal and hepatic disorders, which occurred in 40, 15, 10, 15 and 5% of patients, respectively. Conclusions: The combination of oral EMP and etoposide is considered to be a well-tolerated outpatient treatment regimen for patients with hormone-refractory prostate cancer and the therapy deserves further investigation. [ABSTRACT FROM AUTHOR]

Background: The purpose of the present study was to determine the usefulness of endorectal ultrasonography (ERUS) in assessing rectal wall involvement in intrapelvic tumors. Methods: Rectal wall invasion was assessed in 16 patients; 14 with deeply invasive bladder tumors, one with prostatic leiomyosarcoma, and one with prostatic leiomyoma. Computed tomography (CT), magnetic resonance (MR) imaging and ERUS with a flexible-type radial scanner (7.5 MHz) were used and the results were compared with the histopathologic findings in surgical specimens. Results: The normal rectum was shown by ERUS to be a five- or seven-layer structure. Characteristic abnormal ERUS findings included disappearance of the perirectal fat tissue layer with or without disruption of the propria muscle layer. Endorectal ultrasonography accurately assessed rectal wall involvement in all four patients who had two bladder tumors, plus the one patient with prostatic leiomyoma and the one with prostatic leiomyosarcoma. However, ERUS overstaged one of 12 bladder tumors with no rectal wall involvement, which was strongly adhesive to the rectum because of an inflammatory change but had no tumor invasion. There were no cases of understaging by ERUS. In comparison, CT accurately assessed rectal wall involvement in two patients, but overstaged in three and understaged in two. Magnetic resonance imaging, which was performed in 14 patients, accurately assessed rectal wall involvement in two patients, but overstaged in three and understaged in one. Conclusion: This preliminary study suggests that ERUS more accurately assesses rectal wall involvement in intrapelvic tumor than CT or MRI. [ABSTRACT FROM AUTHOR]