Li Yun-Fei, Zhang Shao-Feng, Zhang Tao-Tao, Li Lei, Gan Wei, Jia Hong-Tao, Xie Sheng, Ji Hui-Hua, He Da-Lin
1] Department of Urology, First Hospital of Xi'an Jiaotong University, Xi'an 710061, China [2] Department of Urology, Affiliated People's Hospital of Hubei Medical University, Shiyan 442000, China.
Asian J Androl. 2013 Nov;15(6):773-9. doi: 10.1038/aja.2013.89. Epub 2013 Aug 19.
Whether continuous docetaxel (DTX) chemotherapy offers an advantage over intermittent therapy for castration-resistant prostate cancer (CRPC) is unknown. In this study, we evaluated the efficacy, toxicity and quality of life (QoL) of intermittent tri-weekly DTX with bicalutamide in CRPC. Forty-two patients (group A) with CRPC were enrolled. The patients received intravenous DTX (75 mg m(-2)) once tri-weekly with oral bicalutamide (50 mg) once daily. Patients had a DTX holiday when the prostate-specific antigen (PSA) level declined ≥50%. DTX was restarted in patients with a PSA increase ≥25%. Sixty patients (group B) who had matching characteristics and had continuously received DTX without bicalutamide for 10-12 cycles were also enrolled. There were no statistically significant differences in progression-free survival (8 months vs. 9 months, P=0.866) or overall survival (19 months vs. 21 months, P=0.753) between groups A and B; however, the proportions of patients in group A with all grades of neutropenia (33% vs. 58%, P=0.013) and nausea/vomiting (11% vs. 29%, P=0.024) were significantly less compared to group B. A significant improvement in the global health and fatigue scores was recorded for group A post-chemotherapy compared to pre-chemotherapy (P<0.05). The fatigue, nausea/vomiting and appetite loss scores in group B were increased post-chemotherapy compared to pre-chemotherapy (P<0.05). In conclusion, intermittent tri-weekly DTX plus bicalutamide is well tolerated and has the potential to achieve comparable disease control with an improvement in QoL for patients with CRPC.
对于去势抵抗性前列腺癌（CRPC）患者，持续多西他赛（DTX）化疗是否优于间歇性化疗尚不清楚。在本研究中，我们评估了CRPC患者接受间歇性每三周一次DTX联合比卡鲁胺治疗的疗效、毒性和生活质量（QoL）。纳入42例CRPC患者（A组）。患者每三周静脉注射一次DTX（75mg/m²），同时每日口服一次比卡鲁胺（50mg）。当前列腺特异性抗原（PSA）水平下降≥50%时，患者停用DTX。PSA升高≥25%的患者重新开始使用DTX。还纳入了60例（B组）具有匹配特征且连续接受10 - 12周期DTX且未使用比卡鲁胺的患者。A组和B组之间的无进展生存期（8个月对9个月，P = 0.866）或总生存期（19个月对21个月，P = 0.753）无统计学显著差异；然而，与B组相比，A组所有级别的中性粒细胞减少症患者比例（33%对58%，P = 0.013）和恶心/呕吐患者比例（11%对29%，P = 0.024）显著更低。与化疗前相比，A组化疗后全球健康和疲劳评分有显著改善（P < 0.05）。与化疗前相比，B组化疗后疲劳、恶心/呕吐和食欲减退评分增加（P < 0.05）。总之，每三周一次间歇性DTX联合比卡鲁胺耐受性良好，对于CRPC患者有可能实现相当的疾病控制并改善生活质量。
