BACKGROUND:The aim of this study was to investigate the efficacy and toxicity of docetaxel-based chemotherapy, and to investigate pretreatment factors that can predict overall survival (OS) in patients with castration-resistant prostate cancer (CRPC).
METHODS: From June 2005 to July 2010, 70 patients with CRPC underwent docetaxel-based chemotherapy at Wakayama Medical University and related hospitals. Docetaxel was given at a dose of 70 mg/m2 once every 3 weeks or 35 mg/m2twice every 3 weeks. Oral estramustine 560 mg was given concurrently for five consecutive days during weeks 1 and 2 of each cycle, and prednisolone 10 mg was given every day. Dexamethasone 8 mg was premedicated intravenously before docetaxel administration.
RESULT:The patients received a median of four cycles of treatment (range 1-31). In the serum prostate-specific antigen response, 13 (18.6 %) patients achieved a complete response and 29 (41.4 %) achieved a partial response. Median OS and time to progression were 14 months and 6 months, respectively. Median follow-up period was 9.5 months. Two independent pretreatment risk factors that predicted OS were visceral metastasis including lymph node metastasis and anemia. Grade 3/4 neutropenia and anemia occurred in 25.7 and 8.6 % of the patients, respectively. Four treatment-related deaths were seen during the observation period.
CONCLUSION: The combination of docetaxel, estramustine and prednisolone was effective in Japanese patients with CRPC; however, this combination therapy should be carefully indicated to elderly and/or poor performance status patients due to its toxicity. Visceral metastasis and anemia were identified as independent risk factors which could predict OS.
Written by:
Kuramoto T, Inagaki T, Fujii R, Sasaki Y, Nishizawa S, Nanpo Y, Matusmura N, Kohjimoto Y, Hara I. Are you the author?
Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
Reference: Int J Clin Oncol. 2012 Aug 31. Epub ahead of print.
doi: 10.1007/s10147-012-0463-z
PubMed Abstract
PMID: 22936562
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