Low-dose docetaxel, estramustine and prednisolone combination chemotherapy for castration-resistant prostate cancer.
The objective of this study was to report our experience with weekly low-dose docetaxel (DOC) chemotherapy for patients with castration-resistant prostate cancer (CRPC). From 2007 to 2014, 39 consecutive patients received weekly low-dose DOC; the oncological effectiveness, side effects and tolerability were prospectively analyzed. The median patient age, serum prostate-specific antigen (PSA) level and Gleason score at diagnosis of prostate cancer were 71 years (range, 55-83 years), 187 ng/ml (range, 2.0-1711 ng/ml) and 8 (range, 5-10), respectively. The median number of cycles of DOC was 7 (range, 1-45 cycles). Of the 39 patients, the PSA level decreased by >50% in 13 (33%). In the multivariate analysis of prediction of patient overall survival, a decrease of the PSA level to <50% was a significant predictor (hazard ratio = 6.913; 95% confidence interval: 1.147-41.669; P=0.035). The median cancer-specific overall survival from the diagnosis of CRPC was 16.7 months (range, 2-54 months). Grade 3 toxicities were observed in 5 patients (13%); specifically, limb edema, nausea and hepatic disorders were detected in 2 (5%), 2 (5%) and 1 patient (3%), respectively. Treatment-related death (grade 5) occurred in 1 patient due to interstitial pneumonia after two courses of chemotherapy. The chemotherapy was completed in the majority of the patients (n=37, 94.8%) in the outpatient department, without interruption. These findings suggest that weekly low-dose DOC is feasible and safe for selected patients with CRPC, without treament with novel agents, such as abiraterone, enzalutamide and cabazitaxel.
Department of Urology, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Mayura
M
Nakano
Department of Urology, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Sunao
S
Shoji
Department of Urology, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Taro
T
Higure
Department of Urology, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Masayoshi
M
Kawakami
Department of Urology, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Tetsuro
T
Tomonaga
Department of Urology, Tokai University School of Medicine, Isehara, Kanagawa 259-1292, Japan.
Toshiro
T
Terachi
Department of Urology, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Toyoaki
T
Uchida
castration-resistant prostate cancer; docetaxel chemotherapy