Journal of Clinical Oncology, Vol 1, 368-379, Copyright © 1983 by American Society of Clinical Oncology
Doxorubicin, mitomycin-C, and 5-fluorouracil (DMF) in the treatment of metastatic hormonal refractory adenocarcinoma of the prostate, with a note on the staging of metastatic prostate cancer
CJ Logothetis, ML Samuels, AC von Eschenbach, A Trindade, S Ogden, C Grant and DE Johnson
Sixty-two patients with metastatic hormonal refractory adenocarcinoma of
the prostate received a combination of doxorubicin, mitomycin-C, and
5-fluorouracil (DMF). Thirty (48%) of the patients achieved an objective
response. Response criteria excluded disease "stabilization" as a
manifestation of response. Four clinical prognostic categories were
identified: osseous I (OI) had metastatic axial skeletal involvement (23
patients); osseous II (OII) had axial and extremity skeletaL involvement
(18 patients); visceral I (VI) had pulmonary metastasis (9 patients); and
visceral II (VII) had pulmonary metastasis and involvement of other viscera
(12 patients). The 20 responding patients survived a median of 47.5 weeks,
whereas the 32 nonresponding patients survived a median of 23.8 weeks (n =
0.002). Response rates were highest among patients with OI (52%) and VI
(88%) disease; response rates were lower amont patients with OII (33%) and
VII (33%) disease. Responding patients in each clinical category survived
longer than nonresponding patients except for those patients with VII
disease. The median duration of response for patients with OI disease was
11 months, for OII 9.5 months, for VI patients it was 6.5 months, and VII
patients it was 5 months. DMF is an effective treatment of metastatic
hormonal refractory prostate cancer, resulting in consistent objective
responses. The staging system employed identifies four clinical categories
of metastatic prostate cancer and allows for accurate comparison of diet
and stratification of study populations.
