Min Kyungchan, Chung Jae Wook, Ha Yun Sok, Lee Jun Nyung, Kim Bum Soo, Kim Hyun Tae, Kim Tae Hwan, Yoo Eun Sang, Kwon Tae Gyun, Chung Sung Kwang, Tanaka Masatoshi, Egawa Shin, Kimura Takahiro, Choi Seock Hwan
Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea.
Department of Urology, Kyungpook National University Hospital, Daegu, Korea.
World J Mens Health. 2020 Apr;38(2):226-235. doi: 10.5534/wjmh.190029. Epub 2019 Jun 4.
The purpose of this study was to determine the comparative effectiveness of androgen deprivation therapy (ADT) combined with docetaxel (DTX)-based chemotherapy in Korean and Japanese castration-resistant prostate cancer (CRPC) patient cohorts.
Metastatic CRPC patients who underwent more than three DTX-based chemotherapy cycles in Korea and Japan between 2002 and 2017 were retrospectively analyzed and divided into the DTX-only (DTX, n=30) and combination (DTX+ADT, n=46) groups. Progression-free survival (PFS) was calculated as the time from the start of chemotherapy to the occurrence of either disease progression (prostate-specific antigen [PSA] progression or radiographic progression) or death. The primary end point was PFS and the secondary end point was overall survival (OS).
In the DTX and DTX+ADT groups, the median PFS was 6.0 and 11.0 months (log-rank p=0.053). The multivariate Cox regression analysis revealed that the significant predicting factors of PFS were ADT administration (hazard ratio [HR], 0.478; 95% confidence interval [CI], 0.284-0.804; p=0.005) and number of DTX-based chemotherapy cycles (HR, 0.934; 95% CI, 0.899-0.970; p<0.001). In the DTX and DTX+ADT groups, the median OS was 16.0 and 19.5 months (log-rank p=0.825). Through multiple Cox regression analysis, we found that the significant predicting factors of OS were the PSA nadir level (HR, 1.001; 95% CI, 1.000-1.002; p<0.001) and number of DTX-based chemotherapy cycles (HR, 0.932; 95% CI, 0.876-0.991; p=0.024).
Concurrent DTX-based chemotherapy and ADT may be beneficial compared with DTX-based chemotherapy alone in chemotherapy-naïve metastatic CRPC patients in terms of the PFS, but not the OS.
本研究旨在确定雄激素剥夺疗法（ADT）联合多西他赛（DTX）为基础的化疗在韩国和日本去势抵抗性前列腺癌（CRPC）患者队列中的相对疗效。
对2002年至2017年间在韩国和日本接受超过三个以DTX为基础的化疗周期的转移性CRPC患者进行回顾性分析，并分为单纯DTX组（DTX，n = 30）和联合组（DTX + ADT，n = 46）。无进展生存期（PFS）计算为从化疗开始到疾病进展（前列腺特异性抗原[PSA]进展或影像学进展）或死亡发生的时间。主要终点是PFS，次要终点是总生存期（OS）。
在DTX组和DTX + ADT组中，中位PFS分别为6.0个月和11.0个月（对数秩检验p = 0.053）。多变量Cox回归分析显示，PFS的显著预测因素是ADT给药（风险比[HR]，0.478；95%置信区间[CI]，0.284 - 0.804；p = 0.005）和以DTX为基础化疗周期的次数（HR，0.934；95% CI，0.89
