title: Risk factors for metastatic castration-resistant prostate cancer (CRPC) predict long-term treatment with docetaxel.
abstract: OBJECTIVE
  For patients with metastatic castration-resistant prostatic cancer (mCRPC), docetaxel plus prednisone leads to superior survival and a higher response rate compared with mitoxantrone plus prednisone. We analyzed the efficacy of long-term treatment with ≥10 cycles of docetaxel, and validated the risk group classification in predicting overall survival (OS) in Japanese patients with mCRPC.
  
  
  METHODS
  Fifty-two patients with mCRPC were administered 55 mg/m(2) docetaxel and 8 mg dexamethasone, every 3 or 4 weeks, simultaneously with hormonal therapy and daily oral dexamethasone. They were divided into two groups, short-term (9 or fewer cycles) and long-term (10 or more cycles). Four risk factors including the presence of anemia, bone metastases, significant pain and visceral metastases were utilized for the risk group classification.
  
  
  RESULTS
  Fourteen patients (27%) had an elevation of PSA in spite of docetaxel treatment, while 23 patients (44%) had a decline in PSA level, including 9 patients (17%) whose PSA level declined by ≥50%. The median duration of OS after the initiation of this therapy was 11.2 months in the short-term group and 28.5 months in the long-term group. The good risk group showed a significant difference in OS compared with the intermediate and poor risk groups (P<0.001). The median number of cycles of treatment was 14, 4 and 3 for each risk group, respectively (p<0.01).
  
  
  CONCLUSIONS
  The present study indicated that ≥10 cycles of this docetaxel therapy can significantly prolong survival in Japanese men with CRPC. This risk group classification for men with mCRPC at the initiation of this chemotherapy is useful.
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawahara
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Miyoshi
authors.forename: Zenkichi
authors.initials: Z
authors.lastname: Sekiguchi
authors.forename: Futoshi
authors.initials: F
authors.lastname: Sano
authors.forename: Narihiko
authors.initials: N
authors.lastname: Hayashi
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Teranishi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Misaki
authors.forename: Kazumi
authors.initials: K
authors.lastname: Noguchi
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kubota
authors.forename: Hiroji
authors.initials: H
authors.lastname: Uemura
mesh_terms: D000368:Aged; D000740:Anemia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D003907:Dexamethasone / Q000008:administration & dosage; D000077143:Docetaxel; D019008:Drug Resistance, Neoplasm; D006801:Humans; D053208:Kaplan-Meier Estimate; D008134:Long-Term Care; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012307:Risk Factors; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D003907:Dexamethasone; D017430:Prostate-Specific Antigen