Exceptional response after metronomic chemotherapy and palliative radiotherapy in castration-resistant prostate cancer: A case report
Authors: Alessio Giuseppe Morganti, Gabriella Macchia, Rezarta Frakulli, Andrea Milanoi, Francesco Massari, Maria Ntreta, Giambattista Siepe, Alessandra Arcelli, Silvia Cammelli, Giuseppe Zanirato Rambaldi, Michelangelo Fiorentino, Francesco Deodato
Background Castration-resistant prostate cancer (CRPC) has a dismal prognosis. Despite treatment, median survival of these patients is around 12-22 months. Case Presentation In this report, we present the case of a 71-year-old man, with CRPC and painful bone metastases treated with an association of middle-half-body radiotherapy, androgen deprivation therapy (ADT) and cyclophosphamide-based metronomic chemotherapy. Five years after palliative radiotherapy the patient is still receiving metronomic chemotherapy and ADT. He is totally asymptomatic, with undetectable PSA values and negative 18F-Choline-PET/CT. The only side-effect was the development of non-insulin-dependent diabetes. Conclusion This treatment for its tolerability and feasibility, it could be particularly useful in older patients with CRPC. Furthermore, considering the low costs, it could be an important therapeutic option for patients living in low-resourced countries.
Keywords: Metronomic chemotherapy, radiotherapy, prostate neoplasms, CRPC, case report
Authors
Alessio Giuseppe Morganti
Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
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Rezarta Frakulli
Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
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Andrea Milanoi
Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
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Maria Ntreta
Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
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Giambattista Siepe
Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
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Alessandra Arcelli
Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
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Silvia Cammelli
Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
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Giuseppe Zanirato Rambaldi
Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
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Correspondence to:
Rezarta Frakulli, Radiotherapy Center, Departments of Experimental, Diagnostic and Specialty Medicine - DIMES Radiation Oncology Center, University of Bologna, SOrsola-Malpighi Hospital, Bologna, Italy rezarta.frakulli@gmail.com
Publication history:
Received 10 Jun 2017
Revised 23 Jul 2017
Accepted 31 Jul 2017
Published in print 22 Sep 2017