Umberto I Hospital, Medical Oncology Unit - Rete Assisstenza Oncologica, Siracusa, Italy.
Prostate Int. 2016 Mar;4(1):15-9. doi: 10.1016/j.prnil.2015.12.003. Epub 2016 Jan 21.
In elderly patients affected by metastatic castration-resistant prostate cancer (mCRPC) chemotherapic treatment may be the choice if one considers not only the chronological age, but also the clinical status, the functional reserve, and the vulnerability of patients. Several studies have confirmed the survival benefit of docetaxel and vinorelbine among every class of age. Most CRP elderly patients are defined as frail, maybe due to comorbidities: these patients, who are unable to be candidates for a standard treatment, should be candidates for a more tolerable treatment.
Twenty-six elderly, frail patients were evaluated. The patients were affected by mCRPC and were receiving chemotherapy with intravenous weekly docetaxel (12 patients) or oral metronomic vinorelbine (14 patients). Safety and efficacy were investigated evaluating clinical and objective response and tolerability. The level of patient satisfaction with treatment was assessed through a questionnaire.
No significant difference was found between groups in terms of 6-month progression-free survival: 57.1% for patients treated with oral metronomic vinorelbine versus 58.3% for patients treated with docetaxel. Median progression free survival was 8.6 months (95% confidence interval: 7.1-9.4 months), and 8.2 months (95% confidence interval: 6.9-9.3 months) for patients treated with oral metronomic vinorelbine and socetaxel, respectively. Oral metronomic vinorelbine was associated with increased patient satisfaction with respect to docetaxel administration. The most frequent side effect associated with oral metronomic vinorelbine was anemia and vomiting, with similar frequency compared to patients treated with docetaxel.
Weekly docetaxel and oral metronomic vinorelbine are equally effective and well tolerated in elderly unfit and frail patients affected by mCRPC. Metronomic vinorelbine treatment is associated with higher patient compliance and satisfaction.
对于转移性去势抵抗性前列腺癌（mCRPC）的老年患者，如果不仅考虑到年龄的因素，还要考虑到患者的临床状况、功能储备和脆弱性，那么化疗可能是一种选择。多项研究证实，在每个年龄组中，多西他赛和长春瑞滨都能提高生存率。大多数 mCRPC 老年患者被定义为虚弱型，可能是由于合并症：这些无法接受标准治疗的患者应该是更耐受治疗的候选者。
对 26 名体弱的老年患者进行了评估。这些患者患有 mCRPC，正在接受每周静脉注射多西他赛（12 名患者）或口服节拍式长春瑞滨（14 名患者）化疗。通过评估临床和客观反应以及耐受性，对安全性和疗效进行了研究。通过问卷调查评估患者对治疗的满意度。
两组患者在 6 个月无进展生存率方面无显著差异：口服节拍式长春瑞滨组为 57.1%，多西他赛组为 58.3%。中位无进展生存期为 8.6 个月（95%置信区间：7.1-9.4 个月），口服节拍式长春瑞滨组和多西他赛组分别为 8.2 个月（95%置信区间：6.9-9.3 个月）。与多西他赛相比，口服节拍式长春瑞滨治疗与患者满意度的提高有关。口服节拍式长春瑞滨最常见的副作用是贫血和呕吐，与多西他赛组相似。
每周多西他赛和口服节拍式长春瑞滨在 mCRPC 虚弱型老年患者中同样有效且耐受良好。节拍式长春瑞滨治疗与更高的患者依从性和满意度相关。
