Zhang Hai Liang, Ye Ding Wei, Yao Xu Dong, Dai Bo, Zhang Shi Lin, Shen Yi Jun, Zhu Yao, Zhang Wen
Department of Urology, Cancer Hospital, Fudan University, Shanghai, PR China.
Urol Int. 2007;79(4):307-11. doi: 10.1159/000109714.
To preliminarily investigate the efficacy of docetaxel plus prednisone and mitoxantrone plus prednisone for treating metastatic hormone-refractory prostate cancer and to further evaluate its adverse events in Chinese patients.
83 patients with metastatic hormone-refractory prostate cancer were enrolled in the trial and given a combination of docetaxel 75 mg/m(2) intravenously on day 2 or mitoxantrone 12 mg/m(2) on day 1 plus prednisone 5 mg twice daily on days 1-21, 21 days a cycle. Serum PSA level, relief of bone pain, myelosuppression, and vomiting were recorded and calculated.
Docetaxel plus prednisone was administered to 44 patients: 13.6% (6/44) of them achieved complete response, 29.5% (13/44) partial response, 29.5% (13/44) had stable disease, and 27.3% (12/44) had disease progression. The average time to PSA progression was 37.8 weeks (12-101 weeks) in the response and stable disease patients. The 12 patients with disease progression were given MP as salvage therapy, and 16.7% (2/12) achieved a partial response, 25.0% (3/12) had stable disease and formed the new baseline. Only 2 patients died of disease aggravation. Mitoxantrone plus prednisone were given to 39 patients, and 7.7% (3/39) of them achieved complete response, 25.6% (10/39) partial response, 25.6% (10/39) had a stable disease, and 41.0% (16/39) of patients had disease progression. The mean time to PSA progression was 25.3 weeks (8-61 weeks) in the response and stable disease patients. The 14 patients with disease progression were administered DP as a salvage therapy and 7.1% (1/14) achieved complete response, 35.7% (5/14) partial response, and 21.4% (3/14) had stable disease and formed the new baseline. Four patients had died at the last follow-up.
In Chinese patients, docetaxel plus prednisone is better than mitoxantrone plus prednisone in PSA response rate and PSA control, but has a bit more toxicity. When the tumor is resistant to one regimen, the other might still be effective in controlling disease progression.
初步探讨多西他赛联合泼尼松与米托蒽醌联合泼尼松治疗转移性激素难治性前列腺癌的疗效，并进一步评估其在中国患者中的不良事件。
83例转移性激素难治性前列腺癌患者纳入试验，在第2天静脉注射多西他赛75mg/m²或在第1天静脉注射米托蒽醌12mg/m²，同时在第1 - 21天每日两次口服泼尼松5mg，21天为一个周期。记录并计算血清PSA水平、骨痛缓解情况、骨髓抑制及呕吐情况。
44例患者接受多西他赛联合泼尼松治疗：其中13.6%（6/44）达到完全缓解，29.5%（13/44）部分缓解，29.5%（13/44）病情稳定，27.3%（12/44）病情进展。缓解和病情稳定患者的PSA进展平均时间为37.8周（12 - 101周）。12例病情进展患者接受米托蒽醌联合泼尼松作为挽救治疗，16.7%（2/12）达到部分缓解，25.0%（3/12）病情稳定并形成新基线。仅2例患者死于疾病加重。39例患者接受米托蒽醌联合泼尼松治疗，7.7%（3/39）达到完全缓解，25.6%（10/39）部分缓解，25.6%（10/39）病情稳定，41.0%（16/39）患者病情进展。缓解和病情稳定患者的PSA进展平均时间为25.3周（8 - 61周）。14例病情进展患者接受多西他赛联合泼尼松作为挽救治疗，7.1%（1/14）达到完全缓解，35.7%（5/14）部分缓解，21.4%（3/14）病情稳定并形成新基线。最后一次随访时有4例患者死亡。
在中国患者中，多西他赛联合泼尼松在PSA缓解率和PSA控制方面优于米托蒽醌联合泼尼松，但毒性稍大。当肿瘤对一种方案耐药时，另一种方案仍可能有效控制疾病进展。
