Kongsted Per, Svane Inge Marie, Lindberg Henriette, Sengeløv Lisa
Department of Oncology, Herlev University Hospital, Herlev, Denmark.
Department of Oncology, Herlev University Hospital, Herlev, Denmark.
Clin Genitourin Cancer. 2017 Apr;15(2):e281-e287. doi: 10.1016/j.clgc.2016.08.019. Epub 2016 Sep 8.
We investigated the impact of the number of docetaxel cycles administered in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with first-line chemotherapy.
Charts from 421 consecutive patients who initiated standard treatment with docetaxel-based chemotherapy (75 mg/m every 3 weeks) between 2007 and 2013 were reviewed. Patients who received < 6 cycles of docetaxel were excluded from the analysis. Remaining patients were divided into 2 groups on the basis of whether or not ≥ 9 cycles of docetaxel were administered (n = 108 and 184, respectively). Reasons for treatment discontinuation and postdocetaxel treatments were registered. Prostate-specific antigen (PSA) responses were defined as a confirmed ≥ 50% decrease in baseline PSA levels. Overall survival (OS) was calculated from start of therapy using the Kaplan-Meier method. Cox proportional hazards were calculated to estimate the effect of clinical variables on OS.
OS was longer in patients treated with ≥ 9 cycles of docetaxel (21.9 months vs. 17.2 months; P < .0001, log rank). Survival also favored patients treated with ≥ 9 cycles of docetaxel when only patients ending docetaxel because of toxicity or treatment conclusion (22.3 vs. 19.4 months; P = .048, log rank) or patients who achieved a PSA response (22.3 vs. 18.7 months; P = .012, log rank) were evaluated. mCRPC-related prognostic factors and patients who received ≥ 1 subsequent line of therapy post-docetaxel were well balanced.
On the basis of our retrospective findings, a superior OS was found in patients treated with ≥ 9 cycles of docetaxel when adjusting for known prognostic factors. Dose reductions might increase the number of docetaxel cycles administered.
我们研究了一线化疗的转移性去势抵抗性前列腺癌（mCRPC）患者接受多西他赛治疗周期数的影响。
回顾了2007年至2013年间开始接受基于多西他赛的标准化疗（每3周75mg/m²）的421例连续患者的病历。接受多西他赛治疗周期数<6个周期的患者被排除在分析之外。其余患者根据是否接受≥9个周期的多西他赛治疗分为两组（分别为n = 108和184）。记录治疗中断的原因和多西他赛治疗后的后续治疗情况。前列腺特异性抗原（PSA）反应定义为基线PSA水平确认下降≥50%。总生存期（OS）从治疗开始时使用Kaplan-Meier方法计算。计算Cox比例风险以估计临床变量对OS的影响。
接受≥9个周期多西他赛治疗的患者OS更长（21.9个月对17.2个月；P <.0001，对数秩检验）。当仅评估因毒性或治疗结束而结束多西他赛治疗的患者（22.3对19.4个月；P =.048，对数秩检验）或达到PSA反应的患者（22.3对18.7个月；P =.012，对数秩检验）时，生存期也有利于接受≥9个周期多西他赛治疗的患者。mCRPC相关的预后因素以及多西他赛治疗后接受≥1线后续治疗的患者情况均衡。
根据我们的回顾性研究结果，在调整已知预后因素后，接受≥9个周期多西他赛治疗的患者OS更佳。剂量减少可能会增加多西他赛的给药周期数。
