Fumimasa Fukuta1, Hiroshi Kitamura2, Masahiro Yanase3, Keisuke Taguchi4, Atsushi Takahashi5, Yasuharu Kunishima6, Masafumi Miyake7, Hideki Adachi8, Naoki Itoh9, Takaoki Hirose10, Seiji Takagi11, Noriomi Miyao12, Masanori Matsukawa13, Masanori Shigyo14, Naoya Masumori2. 1. Department of Urology, Sapporo Medical University School of Medicine, Sapporo ffukuta@sapmed.ac.jp. 2. Department of Urology, Sapporo Medical University School of Medicine, Sapporo. 3. Department of Urology, Sunagawa City Medical Center, Sunagawa. 4. Department of Urology, Oji General Hospital, Tomakomai. 5. Department of Urology, Hakodate Goryoukaku Hospital, Hakodate. 6. Department of Urology, Hokkaido Social Work Association Obihiro Hospital, Obihiro. 7. Department of Urology, Asahikawa Red Cross Hospital, Asahikawa. 8. Department of Urology, Saiseikai Otaru Hospital, Otaru. 9. Department of Urology, NTT-East Corporation, Sapporo Medical Center, Sapporo. 10. Department of Urology, Japan Community Healthcare Organization Hokkaido Hospital, Sapporo. 11. Department of Urology, Kutchan-Kosei General Hospital, Kutchan. 12. Department of Urology, Muroran City General Hospital, Muroran. 13. Department of Urology, Takikawa Municipal Hospital, Takikawa. 14. Department of Urology, Kushiro Red Cross Hospital, Kushiro, 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.
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 cancerpatients 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.