Yuk Hyeong Dong, Kim Miso, Keam Bhumsuk, Ku Ja Hyeon, Kwak Cheol, Jeong Chang Wook
Department of Internal Urology, College of Medicine, Seoul National University, Seoul, Korea.
Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Prostate Int. 2024 Dec;12(4):219-223. doi: 10.1016/j.prnil.2024.09.002. Epub 2024 Sep 26.
To compare the efficacy and toxicity of docetaxel treatment regimens in metastatic castration-resistant prostate cancer (mCRPC).
We retrospectively analyzed 162 patients diagnosed with mCRPC who underwent docetaxel chemotherapy between 2009 and 2020. The patients were divided into three groups according to the dosage and interval of docetaxel (DCT) chemotherapy regimen: 30 mL/m weekly, 50 mL/m biweekly (every 2 weeks), and 75 mL/m triweekly (every 3 weeks).
There were no significant differences in the prostate-specific antigen (PSA) response rates ( = 0.709). The median time to progression was 3.0 [interquartile range (IQR 2.0-5.3)] months, 5.0 (IQR 2.0-13.0) months, and 5.0 (IQR 3.0-12.0) months in the weekly, biweekly, and triweekly groups, respectively ( = 0.062). The median overall survival (OS) was 12.5 (IQR 6.0-14.0) months, 18.8 (IQR 5.5-23.5) months, and 22.9 (IQR 11.0-33.0) months in the weekly, biweekly, and triweekly groups, respectively ( < 0.001). There were no differences in all toxicity and Grade 3 or higher toxicity. In Cox multivariate regression analysis, the Eastern Cooperative Oncology Group performance status (ECOG-PS), response to chemotherapy, and chemotherapy cycle also affected the PFS. Age, ECOG-PS, and chemotherapy cycle affected the OS.
The various options for optimal chemotherapy are indicated depending on the patient's conditions during the diagnosis of mCRPC. Treatment with DCT at 2-week or even 1-week intervals appears to be well tolerated in men diagnosed with mCRPC and represents a useful option when the conventional triweekly regimen is not tolerated due to poor patient condition.
比较多西他赛治疗方案在转移性去势抵抗性前列腺癌（mCRPC）中的疗效和毒性。
我们回顾性分析了2009年至2020年间162例诊断为mCRPC并接受多西他赛化疗的患者。根据多西他赛（DCT）化疗方案的剂量和间隔时间将患者分为三组：每周30 mL/m²、每两周50 mL/m²（每2周一次）和每三周75 mL/m²（每3周一次）。
前列腺特异性抗原（PSA）反应率无显著差异（P = 0.709）。每周、每两周和每三周治疗组的中位疾病进展时间分别为3.0 [四分位间距（IQR 2.0 - 5.3）]个月、5.0（IQR 2.0 - 13.0）个月和5.（IQR 3.0 - 12.0）个月（P = 0.062）。每周、每两周和每三周治疗组的中位总生存期（OS）分别为12.5（IQR 6.0 - 14.0）个月、18.8（IQR 5.5 - 23.5）个月和22.9（IQR 11.0 - 33.0）个月（P < 0.001）。所有毒性和3级及以上毒性方面无差异。在Cox多因素回归分析中，东部肿瘤协作组体能状态（ECOG-PS）、化疗反应和化疗周期也影响无进展生存期（PFS）。年龄、ECOG-PS和化疗周期影响总生存期（OS）。
在mCRPC诊断期间，应根据患者情况选择最佳化疗方案。对于诊断为mCRPC的男性患者，每2周甚至1周间隔的DCT治疗耐受性良好，当患者因病情较差无法耐受传统的每3周治疗方案时，这是一个有用的选择。
