Chemotherapy With Docetaxel Plus Prednisone for Advanced Prostate Cancer: A Retrospective Study of the Time to Clinical Endpoints
Keywords:Retrospective study, hormone-refractory prostate cancer (HRPC), prostate-specific antigen (PSA), natural history, survival analysis
Objective: To determine the treatment efficacy of chemotherapy, overall survival of patients with advanced prostate cancer who started initial androgen-deprivation therapy (ADT) then were treated with chemotherapy when hormone-refractory prostate cancer (HRPC) developed.
Materials and Methods: We retrospectively assessed data from medical records of 35 advanced prostate cancer patients who visited at Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok from 2002 to 2004. Twenty-two patients were included in criteria. Thirteen patients were treated with second-line hormonal therapy (D1) and 9 patients were treated with docetaxel plus prednisone (D2). Both groups were assessed for prostate-specific antigen (PSA) nadir, time to nadir, overall survival since HRPC, overall survival since diagnosis and Kanofsky Performance Status Scale, which were assessed at 6, 12, 24 months after treatment.
Results: ADT was initiated after the diagnosis of advanced prostate cancer in 22 patients. After followed up, the patients who developed HRPC were treated without chemotherapy in D1 group and with chemotherapy in D2 group. Mean PSA nadir was 10.99+15.39 ng/ml and 9.78+14.90 ng/ml. Time to PSA nadir was 10.30+11.37 months and 5+2.78 months. Mean overall survival since HRPC was 19.71+8.57 months and 23.12+12.11 months. Mean overall survival since ADT was 44.14+22.11 months and 33.87+ 14.32 months. Mean overall survival since diagnosis was 45+22.32 months and 34.6+14.16 months. Kanofsky Performance Status Scale after 6 months of treatment was 79.23+6.40 and 83.33+7.07, after 12 months was 60+10.80 and 67.5+15.8, after 24 months was 60+10 and 62.5+15 in D1 and D2 patients, respectively.
Conclusions: We described the natural history of advanced prostate cancer in patients who were treated with and without chemotherapy. The results suggested a longer survival and better performance status in chemotherapeutic group.
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