title: [Salvage therapy for castration-refractory prostate cancer resistant to docetaxel].
abstract: OBJECTIVE
  To evaluate the treatment for castration-refractory prostate cancer (CRPC) resistant to docetaxel
  
  
  METHODS
  Among 45 patients with CRPC treated with docetaxel (70-75 mg/m2) every 3 to 4 weeks at Hamamatsu University Hospital from January 2004 to July 2012, 19 patients underwent salvage treatments. We retrospectively analyzed the medical records of 14 patients except for 5 patients who were enrolled in clinical trials.
  
  
  RESULTS
  The median age and serum prostate-specific antigen (PSA) level at starting salvage treatments was 71 years (range 45 to 79) and 241.1 ng/mL (range 3.06 to 1,643.0), respectively. All patients maintained castration status. Salvage treatments include DTX (30 mg/m2) + cisplatin (CDDP) (70 mg/m2)/carboplatin (Area under the curve = 4), etoposide + CDDP, paclitaxel + CDDP, cyclophosphamide, S-l, tegaful-uracil. The reasons why 14 patients moved to salvage treatments after DTX were progressive disease in 12 patients and adverse events in 2. Eight patients had a PSA response, 3 patients>50% and 5 patients<50%. Six patients had a PSA progression. The median overall survival was 10.4 months (range 4.1 to 27.3). All patients died of cancer, 13 patients with prostate cancer and one patient with lung adenocarcinoma. Most adverse events were mild. Transitory grade 3 leukopenia was observed in 2 patients, and grade 3 anemia in 2. No grade 4 toxicities were noted.
  
  
  CONCLUSIONS
  All salvage treatments without grade 4 toxicities described in this study may be acceptable in the patients with CRPC progressing after docetaxel although the effect would be limited.
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine. ttakayam@hama-med.ac.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takayama
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sugiyama
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furuse
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yajima
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Fumitake
authors.initials: F
authors.lastname: Kai
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Masao
authors.initials: M
authors.lastname: Nagata
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Otsuka
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ishii
authors.affiliation: Department of Urology, Hamamatsu University School of Medicine.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Ozono
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D003520:Cyclophosphamide / Q000008:administration & dosage; D000077143:Docetaxel; D004338:Drug Combinations; D019008:Drug Resistance, Neoplasm; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy*; D016879:Salvage Therapy; D013308:Streptonigrin; D043823:Taxoids / Q000008:administration & dosage / Q000627:therapeutic use*; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D043823:Taxoids; C079133:retrostatin; C079198:S 1 (combination); D005641:Tegafur; D000077143:Docetaxel; D013308:Streptonigrin; D014498:Uracil; D010094:Oxonic Acid; D005047:Etoposide; D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin