ABSTRACT
PURPOSE: To evaluate the antitumor activity of 96-hour paclitaxel and daily oral estramustine phosphate (EMP) in patients with metastatic hormone-refractory prostate cancer (HRPC). PATIENTS AND METHODS: Thirty-four patients with adenocarcinoma of the prostate that progressed after one or more hormonal therapies and a trial of antiandrogen withdrawal were enrolled onto this phase II trial. Patients received paclitaxel 120 mg/m2 by 96-hour intravenous (i.v.) infusion on days 1 through 4 of each 21-day cycle, together with daily oral EMP 600 mg/m2/d, continuously. RESULTS: Four of nine patients with measurable disease had objective responses (one complete response [CR] and three partial responses [PRs]) in liver (two patients) or nodes (two patients) of 2, 6, 8, and 20 months' duration. Of 25 assessable patients with metastases limited to bone, 14 had a > or = 50% decline in pretreatment prostate-specific antigen (PSA) level sustained for at least 6 weeks and seven had a > or = 80% decline. Overall, 17 of 32 patients (53.1%) with elevated pretreatment PSA levels had a > or = 50% decline of PSA and nine (28.1%) had a > or = 80% decrease. The main toxicities (> or = grade 2) were nausea, fluid retention, and fatigue, which occurred in 33%, 33%, and 24.2% of patients. Median time to progression, based on increasing PSA level and other clinical criteria, was 22.5 weeks. The estimated median overall survival time is 69 weeks. CONCLUSION: The combination of EMP and 96-hour paclitaxel is an active regimen for patients with HRPC. These results further support the therapeutic strategy of combining agents that impair microtubule function by complementary mechanisms.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Prostatic Neoplasms/drug therapy , Administration, Oral , Adult , Aged , Aged, 80 and over , Antineoplastic Agents, Alkylating/administration & dosage , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Disease-Free Survival , Drug Administration Schedule , Estramustine/administration & dosage , Humans , Infusions, Intravenous , Male , Middle Aged , Paclitaxel/administration & dosage , Survival Analysis , Treatment OutcomeABSTRACT
PURPOSE/OBJECTIVE: To present a booklet designed to educate patients and their families about peripheral blood stem cell transplantation (PBSC). DATA SYNTHESIS: The booklet describes the procedure, self-care, preliminary chemotherapy regimens, necessary follow-up tests, and appropriate resources. CONCLUSIONS: Preliminary evaluation indicates the booklet has been well-received and appreciated by patients and nursing staff alike. IMPLICATIONS FOR NURSING PRACTICE: The booklet supplements basic patient education in regard to PBSC, anticipates patient questions, and provides patients and families with a take-home, written resource.
Subject(s)
Blood Component Transfusion/methods , Family , Pamphlets , Patient Education as Topic/methods , Stem Cell Transplantation , Teaching Materials , Aftercare , Blood Component Transfusion/nursing , Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use , Humans , Nursing Evaluation Research , Self Administration , Self CareABSTRACT
Peripheral blood stem cell transplantation (PBSCT) is the process of removing circulating stem cells from the peripheral blood through apheresis and returning these cells to the patient after dose-intensive chemotherapy. Clinical trials using PBSCT and dose-intensive chemotherapy are underway at cancer centers across the country. Nurses caring for patients who are undergoing PBSCT need an understanding of all aspects of the process in order to competently manage the toxicities, as well as to educate patients, families, and other staff. Nurses need to consider issues for nursing research to improve the quality of life for these patients.
