Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Urol Oncol. 2013 Aug;31(6):733-8. doi: 10.1016/j.urolonc.2011.06.006. Epub 2011 Jul 22.
To retrospectively review the oncologic outcomes of docetaxel-based chemotherapy in Japanese men with metastatic castration-resistant prostate cancer (mCRPC).
This study included 257 consecutive Japanese patients with mCRPC who were treated with docetaxel-based chemotherapy between April 2007 and March 2010. The prognostic significance of several clinicopathologic factors in these patients was analyzed.
In these 257 patients, the median age and serum value of prostate-specific antigen (PSA) prior to docetaxel-based chemotherapy were 72 years and 43.0 ng/ml, respectively. Of these patients, 64 (24.9%) and 193 (75.1%) received docetaxel as a weekly (30 mg/m(2)) and 3-weekly (70-75 mg/m(2)) regimen, respectively, and estramustine (EM) was administered in combination with docetaxel in 137 (53.3%). PSA decline was observed in 205 patients (79.8%), including 143 (55.6%) achieving PSA decline ≥ 50%. The median progression-free survival and overall survival (OS) were 4.3 and 25.4 months, respectively. Of several factors examined, univariate analysis identified performance status (PS), PSA value, significant clinical pain, bone metastasis, prior treatment with EM, treatment cycle, and PSA response as significant predictors of OS, of which only PS, significant clinical pain, prior treatment with EM, treatment cycle, and PSA response appeared to be independently related to OS on multivariate analysis. Furthermore, there were significant differences in OS according to positive numbers of these 5 independent risk factors.
Oncologic outcomes in Japanese mCRPC patients receiving docetaxel-based chemotherapy is generally favorable, and the risk stratification presented in this study may contribute to precisely predicting the prognosis of such patients.
回顾分析多西他赛为基础化疗在日本转移性去势抵抗性前列腺癌（mCRPC）患者中的肿瘤学疗效。
本研究纳入了 257 例自 2007 年 4 月至 2010 年 3 月接受多西他赛为基础化疗的 mCRPC 日本患者。分析了这些患者的几种临床病理因素的预后意义。
257 例患者的中位年龄和多西他赛化疗前前列腺特异性抗原（PSA）值分别为 72 岁和 43.0ng/ml。其中 64 例（24.9%）和 193 例（75.1%）接受了每周（30mg/m2）和每 3 周（70-75mg/m2）的多西他赛方案，137 例（53.3%）患者接受了多西他赛联合雌莫司汀（EM）治疗。205 例（79.8%）患者出现 PSA 下降，其中 143 例（55.6%）PSA 下降≥50%。中位无进展生存期和总生存期（OS）分别为 4.3 个月和 25.4 个月。单因素分析确定了体能状态（PS）、PSA 值、显著临床疼痛、骨转移、既往 EM 治疗、治疗周期和 PSA 反应是 OS 的显著预测因素，其中仅 PS、显著临床疼痛、既往 EM 治疗、治疗周期和 PSA 反应在多因素分析中与 OS 独立相关。此外，根据这 5 个独立危险因素的阳性数量，OS 存在显著差异。
接受多西他赛为基础化疗的日本 mCRPC 患者的肿瘤学疗效普遍较好，本研究提出的风险分层可能有助于准确预测此类患者的预后。
