Shen Yuan-Chi, Chiang Po-Hui, Luo Hao-Lun, Chuang Yao-Chi, Chen Yen-Ta, Kang Chih-Hsiung, Hsu Chun-Chien, Lee Wei-Ching, Cheng Yuan-Tso
Department of Urology, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung, Taiwan, ROC.
Department of Urology, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung, Taiwan, ROC.
Kaohsiung J Med Sci. 2016 Sep;32(9):458-63. doi: 10.1016/j.kjms.2016.07.012. Epub 2016 Aug 30.
To determine the optimal number of cycles of docetaxel for metastatic castration-resistant prostate cancer, we retrospectively collected 73 patients receiving varying numbers of docetaxel plus prednisolone and analyzed the clinical outcomes including overall survival, prostate-specific antigen (PSA) response, and adverse events. The study included 33 patients receiving ≤ 10 cycles of docetaxel and 40 patients receiving > 10 cycles. Patients receiving > 10 cycles were younger than those who received ≤ 10 cycles. There was no statistical significant difference in overall survival between the two groups (log-rank test, p = 0.75). Adverse effects were more common among patients receiving ≥ 10 cycles of treatment. A PSA flare-up was observed among six patients (8.2%); the median duration of the PSA surge was 3 weeks (range, 3-12 weeks). The overall survival rates in patients with PSA flare-up were comparable with the patients having PSA response. We concluded that at least four cycles of docetaxel should be administered in metastatic castration-resistant prostate cancer patients in order not to cease treatment prematurely from potentially beneficial chemotherapy. However, administering > 10 cycles does not result in any further improvement in survival and is associated with more adverse effects.
为确定转移性去势抵抗性前列腺癌多西他赛的最佳化疗周期数，我们回顾性收集了73例接受不同周期多西他赛加泼尼松治疗的患者，并分析了包括总生存期、前列腺特异性抗原（PSA）反应及不良事件在内的临床结局。该研究纳入了33例接受≤10周期多西他赛治疗的患者和40例接受>10周期治疗的患者。接受>10周期治疗的患者比接受≤10周期治疗的患者更年轻。两组患者的总生存期无统计学显著差异（对数秩检验，p = 0.75）。不良反应在接受≥10周期治疗的患者中更为常见。6例患者（8.2%）出现PSA激增；PSA激增的中位持续时间为3周（范围3 - 12周）。出现PSA激增患者的总生存率与出现PSA反应的患者相当。我们得出结论，转移性去势抵抗性前列腺癌患者应至少接受4周期多西他赛治疗，以免因潜在有益的化疗而过早停止治疗。然而，接受>10周期治疗并不能进一步提高生存率，且会带来更多不良反应。
