Risk Factors for Metastatic Castration-Resistant Prostate Cancer (CRPC) Predict Long-Term Treatment with Docetaxel 英文参考文献.docVIP

RiskFactorsforMetastaticCastration-ResistantProstate Cancer(CRPC)PredictLong-TermTreatmentwith Docetaxel TakashiKawahara1,YasuhideMiyoshi2,ZenkichiSekiguchi1,FutoshiSano1,NarihikoHayashi1 ,Jun- ichiTeranishi2,HiroshiMisaki3,KazumiNoguchi2,YoshinobuKubota1,HirojiUemura1* 1Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan, 2Department of Urology, Yokohama City University MedicalCenter,Yokohama,Kanagawa,Japan,3DepartmentofUrology,YamatoCityHospital,Yamato,Kanagawa,Japan Abstract Purpose: For patients with metastatic castration-resistant prostatic cancer (mCRPC), docetaxel plus prednisone leads to superior survival and a higher response rate compared with mitoxantrone plus prednisone. We analyzed the efficacy of long-termtreatmentwith$10cyclesofdocetaxel,andvalidatedtheriskgroupclassificationinpredictingoverallsurvival (OS)inJapanesepatientswithmCRPC. PatientsandMethods:Fifty-twopatientswithmCRPCwereadministered55mg/m2docetaxeland8mgdexamethasone, every 3 or 4 weeks, simultaneously with hormonal therapy and daily oral dexamethasone. They were divided into two groups,short-term(9orfewercycles)andlong-term(10ormorecycles).Fourriskfactorsincludingthepresenceofanemia, bonemetastases,significantpainandvisceralmetastaseswereutilizedfortheriskgroupclassification. Results: Fourteen patients (27%) had an elevation of PSA in spite of docetaxel treatment, while 23 patients (44%) had adeclineinPSAlevel,including9patients(17%)whosePSAleveldeclinedby$50%.ThemediandurationofOSafterthe initiationofthistherapywas11.2monthsintheshort-termgroupand28.5monthsinthelong-termgroup.Thegoodrisk groupshowedasignificantdifferenceinOScomparedwiththeintermediateandpoorriskgroups(P,0.001).Themedian numberofcyclesoftreatmentwas14,4and3foreachriskgroup,respectively(p,0.01). Conclusions: The present study indicated that $10 cycles of this docetaxel therapy can significantly prolong survival in JapanesemenwithCRPC.Thisriskgroupclassificationformenwit