title: Central nervous system metastases from castration-resistant prostate cancer in the docetaxel era.
abstract: Central nervous system (brain or leptomeningeal) metastases (BLm) are considered rare in castration-resistant prostate cancer (CRPC) patients. Now that docetaxel has become the reference drug for first-line treatment of CRPC, patients whose disease is not controlled by hormonal manipulations may live much longer than before and have higher risk of developing BLm. We retrospectively reviewed the records of all patients with CRPC attending our centres from 2002 to 2010, and identified all of those who were diagnosed as having BLm and received (or were considered to have been eligible to receive) docetaxel-based treatment. We identified 31 cases of BLm (22 brain metastases and 9 leptomeningeal metastases) with an incidence of 3.3%. BLm-free survival was 43.5 months, and survival after BLm discovery was 4 months. With six patients surviving for more than 1 year after developing BLm, the projected 1-year BL-S rate was 25.8%. The findings of our study may be relevant in clinical practice as they indicate that incidence of BLm in CRPC patients in the docetaxel era seems to be higher than in historical reports, meaning that special attention should be paid to the appearance of neurological symptoms in long-term CRPC survivors because they may be related to BLm.
authors: Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d'Oro, 38100 Trento, Italy. orazio.caffo@apss.tn.it
authors: Orazio
authors: O
authors: Caffo
authors: Angela
authors: A
authors: Gernone
authors: Cinzia
authors: C
authors: Ortega
authors: Teodoro
authors: T
authors: Sava
authors: Giacomo
authors: G
authors: Cartenì
authors: Gaetano
authors: G
authors: Facchini
authors: Giovanni Lo
authors: GL
authors: Re
authors: Placido
authors: P
authors: Amadio
authors: Roberto
authors: R
authors: Bortolus
authors: Vincenzo
authors: V
authors: Pagliarulo
authors: Veronica
authors: V
authors: Prati
authors: Antonello
authors: A
authors: Veccia
authors: Enzo
authors: E
authors: Galligioni
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D001932:Brain Neoplasms / Q000139:chemically induced / Q000401:mortality / Q000556:secondary*; D000077143:Docetaxel; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000139:chemically induced / Q000401:mortality / Q000556:secondary*; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D015996:Survival Rate; D043823:Taxoids / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel