title: Docetaxel in combination with estramustine and prednisolone for castration-resistant prostate cancer.
abstract: BACKGROUND
  The aim of this study was to investigate the efficacy and toxicity of docetaxel-based chemotherapy, and to investigate pretreatment factors that can predict overall survival (OS) in patients with castration-resistant prostate cancer (CRPC).
  
  
  METHODS
  From June 2005 to July 2010, 70 patients with CRPC underwent docetaxel-based chemotherapy at Wakayama Medical University and related hospitals. Docetaxel was given at a dose of 70 mg/m(2) once every 3 weeks or 35 mg/m(2) twice every 3 weeks. Oral estramustine 560 mg was given concurrently for five consecutive days during weeks 1 and 2 of each cycle, and prednisolone 10 mg was given every day. Dexamethasone 8 mg was premedicated intravenously before docetaxel administration.
  
  
  RESULTS
  The patients received a median of four cycles of treatment (range 1-31). In the serum prostate-specific antigen response, 13 (18.6%) patients achieved a complete response and 29 (41.4%) achieved a partial response. Median OS and time to progression were 14 months and 6 months, respectively. Median follow-up period was 9.5 months. Two independent pretreatment risk factors that predicted OS were visceral metastasis including lymph node metastasis and anemia. Grade 3/4 neutropenia and anemia occurred in 25.7 and 8.6% of the patients, respectively. Four treatment-related deaths were seen during the observation period.
  
  
  CONCLUSIONS
  The combination of docetaxel, estramustine and prednisolone was effective in Japanese patients with CRPC; however, this combination therapy should be carefully indicated to elderly and/or poor performance status patients due to its toxicity. Visceral metastasis and anemia were identified as independent risk factors which could predict OS.
authors.affiliation: Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan, tkuramoto@kinan-hp.tanabe.wakayama.jp.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kuramoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inagaki
authors.forename: Reona
authors.initials: R
authors.lastname: Fujii
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishizawa
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Nanpo
authors.forename: Nagahide
authors.initials: N
authors.lastname: Matusmura
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kohjimoto
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D019008:Drug Resistance, Neoplasm / Q000187:drug effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000401:mortality / Q000473:pathology; D004961:Estramustine / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D017430:Prostate-Specific Antigen / Q000097:blood; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D004961:Estramustine; D011239:Prednisolone; D017430:Prostate-Specific Antigen