title: Feasibility of classical secondary hormonal therapies prior to docetaxel therapy in Japanese patients with castration-resistant prostate cancer: Multicenter retrospective study.
abstract: BACKGROUND
  We retrospectively analyzed castration-resistant prostate cancer (CRPC) patients treated with secondary hormonal therapies (SHTs) prior to docetaxel therapy.
  
  
  METHODS
  The cases of 73 CRPC patients who underwent docetaxel therapy in 2005-2011 at four hospitals in Ibaraki, Japan were analyzed. We determined the cause-specific survival (CSS) from the start of docetaxel therapy and the time point of CRPC diagnosis, and we compared the CSS achieved with/without prior classical SHTs, which were defined as low-dose steroid and estramustine phosphate.
  
  
  RESULTS
  Of the 73 enrolled patients, 26 underwent docetaxel therapy (DOC group), and 47 underwent SHTs (SHTs-DOC group) as the initial treatment for CRPC. In the docetaxel therapy, the rate of prostate-specific antigen responses were higher in the DOC group compared with the SHTs-DOC group (76.9% vs. 44.7%,P= 0.0066). The median CSS from the docetaxel therapy initiation was not significant but longer in the DOC group than in the SHTs-DOC group (23.4 months vs. 16.6 months,P= 0.0969). However, the median CSS from the time of CRPC diagnosis did not significantly differ between the DOC and SHTs-DOC groups (23.4 months vs. 24.7 months,P= 0.9233). In a univariate analysis, pain and visceral metastasis appeared to be risk factors for the CSS in the SHTs-DOC group. The patients with pain and/or visceral metastasis had significantly poorer survival than those without these factors in the SHTs-DOC group (31.5 months vs. 16.8 months,P= 0.0053).
  
  
  CONCLUSIONS
  The induction of SHTs prior to docetaxel therapy is an acceptable treatment option with some survival benefits for CRPC patients without pain and visceral metastases.
authors.affiliation: Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Shuya
authors.initials: S
authors.lastname: Kandori
authors.affiliation: Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yoshino
authors.affiliation: Department of Urology, Hitachi General Hospital, Hitachi, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Tsutsumi
authors.affiliation: Department of Urology, Ibaraki Prefectural Central Hospital, Kasama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamauchi
authors.affiliation: Department of Urology, Ibaraki Prefectural Central Hospital, Kasama, Japan.
authors.forename: Mikinobu
authors.initials: M
authors.lastname: Ohtani
authors.affiliation: Department of Urology, Mito Saiseikai General Hospital, Mito, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Fukuhara
authors.affiliation: Department of Urology, Mito Saiseikai General Hospital, Mito, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Miyanaga
authors.affiliation: Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Miyazaki
authors.affiliation: Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
authors.affiliation: Department of Urology, Ibaraki Prefectural Central Hospital, Kasama, Japan; Department of Urology, Ibaraki Clinical Education and Training Center, Faculty of Medicine, University of Tsukuba, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Shimazui
keywords: Castration-resistant prostate cancer; Cause-specific survival; Docetaxel; Secondary hormonal therapies