Evaluation of the efficacy and clinical effectiveness of estramustine (Adelax) in the treatment of prostate cancer

Estramustine (Estramustine) is a compound chemotherapy drug that combines estrogen and an alkylating agent. It is mainly used for the treatment of advanced or metastatic prostate cancer. It interferes with cell division by inhibiting microtubule assembly and exerts estrogenic effects to inhibit the growth of androgen-dependent prostate cancer cells, thereby delaying tumor progression and improving clinical symptoms.

In single-agent use, estramustine can achieve a certain decrease in prostate-specific antigen (PSA) and tumor burden in patients with advanced prostate cancer. Clinical data shows that about 30% to 50% of patients have a significant decrease in PSA after taking the drug for several weeks to months. At the same time, some patients can experience bone pain relief and improvement in quality of life. However, the efficacy of single drug is limited, and most patients still need to be combined with other hormones or chemotherapy drugs to obtain more ideal results.

Estramustine is often used in combination with testosterone inhibitors or other chemotherapy drugs (such as paclitaxel, doxorubicin), which can significantly improve the remission rate and disease control rate. Combination therapy can prolong progression-free survival (PFS) and overall survival (OS), especially for patients with metastatic or hormone-resistant prostate cancer. Combination regimens also require close monitoring of thrombotic risk and cardiovascular side effects.

Common adverse reactions of estramustine include thrombosis, cardiovascular events, gastrointestinal discomfort, and breast tenderness. Patients need to regularly monitor blood routine, coagulation function and electrocardiogram during treatment, and carry out prevention and intervention based on individual risks. Proper evaluation of efficacy, combined with individualized treatment plans, and strict follow-up can maximize clinical efficacy and improve patients' quality of life while ensuring safety.

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