Takaha Natsuki, Okihara Koji, Kamoi Kazumi, Hongo Fumiya, Iwata Tsuyoshi, Yano Kimihiro, Ueda Takashi, Takeuchi Ichiro, Yamada Takeshi, Kawauchi Akihiro, Miki Tsuneharu
Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ntakaha @ koto.kpu-m.ac.jp
Urol Int. 2011;87(3):263-9. doi: 10.1159/000328217. Epub 2011 Aug 26.
To evaluate the efficacy and safety of docetaxel-based chemotherapy for elderly metastatic castration-resistant prostate cancer (CRPC) patients aged 75 or higher.
Twenty CRPC patients aged 75 or higher (older group) and 31 CRPC patients younger than 75 years (younger group) were treated by a regimen of docetaxel (70 mg/m(2)) once every 3 weeks. Adjustment for docetaxel dosage and period per cycle was subject to investigator's judgment.
The median relative dose intensity of both groups was 0.84, while the median dose intensity and the number of treatment cycles of the younger and older groups were 14.6 versus 12.3 mg/m(2)/week (p = 0.021), and 9 versus 8 cycles (p = 0.15), respectively. In the older group, PSA response rate was 50%, median time to biochemical progression was 7.5 months, and median survival time was 15.5 months, without any significant difference compared to those of the younger group. No significant difference in the incidence of grade 3-4 adverse events was noted between both groups. All these parameters for efficacy are comparable to those reported for tri-weekly docetaxel regimen.
Tri-weekly treatment by docetaxel (70 mg/m(2)) with proper adjustment might contribute to maintaining efficacy and safety of the treatment for elderly CRPC patients.
评估多西他赛为主的化疗方案对75岁及以上老年转移性去势抵抗性前列腺癌（CRPC）患者的疗效和安全性。
20例75岁及以上的CRPC患者（老年组）和31例75岁以下的CRPC患者（年轻组）接受多西他赛（70mg/m²）每3周一次的治疗方案。多西他赛剂量及每周期时长的调整由研究者判断决定。
两组的中位相对剂量强度均为0.84，而年轻组和老年组的中位剂量强度及治疗周期数分别为14.6对比12.3mg/m²/周（p = 0.021），以及9对比8周期（p = 0.15）。老年组的前列腺特异抗原（PSA）反应率为50%，生化进展的中位时间为7.5个月，中位生存时间为15.5个月，与年轻组相比无显著差异。两组之间3-4级不良事件的发生率无显著差异。所有这些疗效参数与每三周一次多西他赛方案报道的参数相当。
每三周一次给予多西他赛（70mg/m²）并适当调整，可能有助于维持老年CRPC患者治疗的疗效和安全性。
