title: Changes in fPSA level could discriminate tPSA flare-up from tPSA progression in patients with castration-refractory prostate cancer during the initial phase of docetaxel-based chemotherapy.
abstract: OBJECTIVE
  To evaluate whether changes in fPSA level could predict tPSA flare-up in patients with castration-refractory prostate cancer during the initial phase of docetaxel-based chemotherapy.
  
  
  METHODS
  We retrospectively identified 79 consecutive patients who received docetaxel-based chemotherapy at our institution. The treatment protocols included docetaxel 75 mg/m² every 21 days, with either prednisone 5 mg twice daily or estramustine 280 mg three times daily on days 1-5; treatment with dexamethasone preceded docetaxel therapy. All PSA values were determined before every cycle of docetaxel-based treatment.
  
  
  RESULTS
  According to changes in tPSA level, 79 patients were divided into 3 groups: response (group 1), progression (group 2) and flare-up (group 3). fPSA and tPSA levels showed different patterns in groups 1, 2 and 3. Changes in fPSA level were independent of the changes in tPSA level in group 3, which decreased during chemotherapy. However, comparing with fPSA changes in group 3, changes in fPSA level were in accordance with tPSA changes in groups 1 and 2. Estimated median survival in groups 1, 2 and 3 was 23, 13 and 21 months, respectively. Median survival for patients in groups 1 (P = 0.008 vs group 2) and 3 (P = 0.029 vs group 2) is significantly longer than for patients who experienced progressive disease under therapy. However, there was no statistically significant difference in survival between groups 1 and 3.
  
  
  CONCLUSIONS
  In the present study, we observed that changes in fPSA level could possibly discriminate tPSA flare-up from tPSA progression in patients with castration-refractory prostate cancer during the initial phase of docetaxel-based chemotherapy.
authors.affiliation: Department of Genitourinary Oncology, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060, China, dujun_1980@hotmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Du
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.forename: Xu-Sheng
authors.initials: XS
authors.lastname: Chen
authors.forename: Jie
authors.initials: J
authors.lastname: Tian
authors.forename: Xin
authors.initials: X
authors.lastname: Yao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018450:Disease Progression; D000077143:Docetaxel; D004961:Estramustine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011467:Prostate / Q000187:drug effects* / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood* / Q000378:metabolism; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D047368:Tumor Burden / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D043823:Taxoids; D000077143:Docetaxel; D004961:Estramustine; D017430:Prostate-Specific Antigen; D011241:Prednisone