title: Efficacy and safety of docetaxel and prednisolone for castration-resistant prostate cancer: a multi-institutional retrospective study in Japan.
abstract: OBJECTIVE
  Although some new drugs for castration-resistant prostate cancer are available, docetaxel still plays an important role in castration-resistant prostate cancer treatment. In this study, we evaluated the efficacy and safety of docetaxel and prednisolone in patients with castration-resistant prostate cancer.
  
  
  METHODS
  We conducted a retrospective chart review of castration-resistant prostate cancer patients who received docetaxel and prednisolone at 14 hospitals in the Sapporo Medical University Urologic Oncology Consortium from August 2004 to December 2011.
  
  
  RESULTS
  A total of 140 patients with castration-resistant prostate cancer received docetaxel and prednisolone (median age, 73.8 years; median prostate specific antigen, 54.7 ng/ml). A median of six cycles (range: 1-43) of docetaxel and prednisolone was administered per patient. Median follow-up was 13.7 months. Median overall survival was 22.0 months. The log-rank test revealed that prostate specific antigen before docetaxel and prednisolone (<50 ng/ml) and the prostate specific antigen reduction rate (≥30%) were associated with overall survival (P < 0.001 and P < 0.001, respectively). Eighty patients (57.1%) achieved a prostate specific antigen reduction rate of over 30%. All except two (97.5%) reached 30% prostate specific antigen reduction within five cycles of docetaxel and prednisolone. There were two (1.4%) treatment-related deaths due to adverse events, which were interstitial lung disease, and febrile neutropenia and bacterial pneumonia. Interstitial lung disease occurred in 14 (10.0%) patients within a median of 2.5 cycles of docetaxel and prednisolone. Grade 5 interstitial lung disease was seen after three cycles of docetaxel and prednisolone.
  
  
  CONCLUSIONS
  If a prostate specific antigen reduction rate of over 30% is not obtained within five cycles of docetaxel and prednisolone, other treatment options should be considered. Although most patients safely received docetaxel and prednisolone, we must always keep interstitial lung disease in mind as a possible lethal adverse event.
authors: Department of Urology, Sapporo Medical University School of Medicine, Sapporo ffukuta@sapmed.ac.jp.
authors: Fumimasa
authors: F
authors: Fukuta
authors: Department of Urology, Sapporo Medical University School of Medicine, Sapporo.
authors: Hiroshi
authors: H
authors: Kitamura
authors: Department of Urology, Sunagawa City Medical Center, Sunagawa.
authors: Masahiro
authors: M
authors: Yanase
authors: Department of Urology, Oji General Hospital, Tomakomai.
authors: Keisuke
authors: K
authors: Taguchi
authors: Department of Urology, Hakodate Goryoukaku Hospital, Hakodate.
authors: Atsushi
authors: A
authors: Takahashi
authors: Department of Urology, Hokkaido Social Work Association Obihiro Hospital, Obihiro.
authors: Yasuharu
authors: Y
authors: Kunishima
authors: Department of Urology, Asahikawa Red Cross Hospital, Asahikawa.
authors: Masafumi
authors: M
authors: Miyake
authors: Department of Urology, Saiseikai Otaru Hospital, Otaru.
authors: Hideki
authors: H
authors: Adachi
authors: Department of Urology, NTT-East Corporation, Sapporo Medical Center, Sapporo.
authors: Naoki
authors: N
authors: Itoh
authors: Department of Urology, Japan Community Healthcare Organization Hokkaido Hospital, Sapporo.
authors: Takaoki
authors: T
authors: Hirose
authors: Department of Urology, Kutchan-Kosei General Hospital, Kutchan.
authors: Seiji
authors: S
authors: Takagi
authors: Department of Urology, Muroran City General Hospital, Muroran.
authors: Noriomi
authors: N
authors: Miyao
authors: Department of Urology, Takikawa Municipal Hospital, Takikawa.
authors: Masanori
authors: M
authors: Matsukawa
authors: Department of Urology, Kushiro Red Cross Hospital, Kushiro, Japan.
authors: Masanori
authors: M
authors: Shigyo
authors: Department of Urology, Sapporo Medical University School of Medicine, Sapporo.
authors: Naoya
authors: N
authors: Masumori
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D000077143:Docetaxel; D006801:Humans; D007564:Japan; D008297:Male; D008499:Medical Records; 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*; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D043823:Taxoids; D000077143:Docetaxel; D011239:Prednisolone; D017430:Prostate-Specific Antigen
keywords: castration-resistant prostate cancer; docetaxel; interstitial lung disease