Tassinari Davide, Tamburini Emiliano, Gianni Lorenzo, Drudi Fabrizio, Fantini Manuela, Santelmo Carlotta, Stocchi Lucia, Montanari Francesco, Sartori Sergio
Department of Oncology, City Hospital, Rimini, c.p.n. 35, 47822 Santarcangelo di Romagna (RN), Italy.
Rev Recent Clin Trials. 2016;11(4):317-323. doi: 10.2174/1574887111666160719145456.
To assess the role of docetaxel plus androgen deprivation in metastatic, hormone- sensitive prostate cancer.
A qualitative systematic review of literature was performed. All the randomized phase III trials comparing docetaxel plus androgen deprivation with androgen deprivation alone in patients with metastatic, hormone-sensitive prostate cancer were considered eligible and included into the analysis.
Six papers (3 randomized clinical trials, and 3 systematic reviews with meta-analysis) were considered eligible and included into the analysis. A significant improvement in time to progression and OS in the entire population treated with docetaxel plus androgen deprivation was reported in all the trials and meta-analyses, and in two trials and all meta-analyses, respectively. One trial reported improvement of OS only in patients with high volume disease, and the meta-analysis that also analyzed the subgroups of patients with high or low volume disease reported a benefit of docetaxel plus androgen deprivation for either the entire population or the two subgroups of patients.
The early use of docetaxel combined with androgen deprivation improves the main outcomes in the treatment of metastatic, hormone-sensitive prostate cancer. The available data suggest that docetaxel plus androgen deprivation could be considered the novel standard for fit patients with metastatic, hormone-sensitive prostate cancer.
评估多西他赛联合雄激素剥夺疗法在转移性激素敏感性前列腺癌中的作用。
对文献进行定性系统评价。所有比较多西他赛联合雄激素剥夺疗法与单纯雄激素剥夺疗法治疗转移性激素敏感性前列腺癌患者的随机III期试验均被视为符合条件并纳入分析。
六篇文献（3项随机临床试验和3项带有荟萃分析的系统评价）被视为符合条件并纳入分析。所有试验和荟萃分析均报告，接受多西他赛联合雄激素剥夺疗法治疗的总体人群在疾病进展时间和总生存期方面有显著改善，分别在两项试验和所有荟萃分析中也有此发现。一项试验报告仅在高负荷疾病患者中总生存期有所改善，并且对高负荷或低负荷疾病患者亚组进行分析的荟萃分析报告，多西他赛联合雄激素剥夺疗法对总体人群或两类患者亚组均有益处。
早期使用多西他赛联合雄激素剥夺疗法可改善转移性激素敏感性前列腺癌治疗的主要结局。现有数据表明，多西他赛联合雄激素剥夺疗法可被视为适合的转移性激素敏感性前列腺癌患者的新治疗标准。
