title: Combination of hemoglobin, alkaline phosphatase, and age predicts optimal docetaxel regimen for patients with castration-resistant prostate cancer.
abstract: BACKGROUND
  We aimed to find the prognostic factors predicting overall survival (OS) in patients with castration-resistant prostate cancer (CRPC) who had docetaxel (DTX) chemotherapy, and to construct a model predicting the optimum number of cycles of DTX.
  
  
  METHODS
  A total of 279 CRPC patients who received DTX (≥50 mg/m(2)) every 3-4 weeks were studied retrospectively. Prognostic factors predicting treatment cycles as well as OS were analyzed, and a risk table for predicting treatment cycles was constructed.
  
  
  RESULTS
  The longer treatment group (>10 cycles) had a significantly longer OS than the standard treatment group (p < 0.0001). Multivariate analysis demonstrated that a decrease of ≥50 % in prostate-specific antigen (PSA), serum markers at the start of DTX therapy [PSA, alkaline phosphatase (ALP), and C-reactive protein (CRP)], and the number of DTX courses were independent predictors of OS. The risk table employing the combination of three factors [ALP (cut-off 189 IU/L), hemoglobin (11.3 g/dL), and age (65 years) at the start of DTX therapy], and scoring based on the hazard ratio of each risk factor (ALP 4, hemoglobin 2, age 3) could effectively predict the probability of the length of DTX therapy, with lower score (0-6) predicting >10 cycles, and higher score (7-9) predicting ≤5 cycles (p < 0.0001). No significant difference was found regarding grade 3/4 adverse events between the two groups.
  
  
  CONCLUSIONS
  A model using three factors prior to chemotherapy may be beneficial for deciding the duration of DTX therapy in patients with CRPC.
authors.affiliation: Department of Urology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan, hidde@yamaguchi-u.ac.jp.
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Matsuyama
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Shimabukuro
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kohjimoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Koike
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Uemura
authors.forename: Taiji
authors.initials: T
authors.lastname: Hayashi
authors.forename: Munehisa
authors.initials: M
authors.lastname: Ueno
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Kodaira
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Tomita
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sakurai
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Shimizu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood*; D054316:Biomarkers, Pharmacological / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D000077143:Docetaxel; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage*
chemical_list: D054316:Biomarkers, Pharmacological; D006454:Hemoglobins; D043823:Taxoids; D000077143:Docetaxel; D002097:C-Reactive Protein; D000469:Alkaline Phosphatase; D017430:Prostate-Specific Antigen