Ten Years of Docetaxel-Based Therapies in Prostate Adenocarcinoma: A Systematic Review and Meta-Analysis of 2244 Patients in 12 Randomized Clinical Trials
Ten Years of Docetaxel-Based Therapies in Prostate Adenocarcinoma: A Systematic Review and Meta-Analysis of 2244 Patients in 12 Randomized Clinical Trials
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DOI：
10.1016/j.clgc.2011.05.002
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发表时间：
2011-12-01
影响因子：
3.2
通讯作者：
Del Giglio, Auro
中科院分区：
文献类型：
--
作者：
Serpa Neto, Ary;Tobias-Machado, Marcos;Del Giglio, Auro
这是一项荟萃分析，旨在巩固已发表的转移性前列腺癌多西紫杉醇治疗与单独使用多西他赛治疗相比的结果。我们在1194例患者中发现，综合治疗取得了良好的效果。研究背景：化疗可降低部分去势耐受前列腺癌(CRPC)患者的血清前列腺特异性抗原(PSA)水平，减轻疼痛。为了提高疗效，许多随机试验研究了基于多西紫杉醇的联合方案。目前的分析试图克服个别试验的统计限制，并调查总体和不同组合组的治疗效果。方法：检索Medline、Embase、Cancerlight和美国临床肿瘤学会摘要数据库，检索已发表的评价多西紫杉醇治疗慢性前列腺癌患者的随机安慰剂对照试验。评估结果为总存活率、总应答率、PSA应答率和不良反应。结果：12篇文章(2244名参与者)进入Meta分析。分析表明，与单独使用多西他赛相比，基于多西他赛的联合用药的PSA应答率更高(相对风险[RR]=1.16；P=0.010)。多西紫杉醇联合用药组的估计中位生存期显著长于单用多西他赛组(22.0个月对18.4个月；P=0.037)。两组患者的3级或4级中性粒细胞减少症以及3级或4级血栓栓塞症事件相似(总体RR为0.87[可信区间(CI)0.71-1.07]；P=0.20，总体RR为1.52[0.79-2.90]；P=0.21)。结论：对12个随机试验的分析为多西紫杉醇联合化疗治疗慢性前列腺癌患者提供了有利的证据，且疗效良好。
This is a meta-analysis that aimed to consolidate the results published on docetaxel-based therapies in metastatic prostate cancer compared with docetaxel alone. We found in 1194 patients, favorable results with the combined therapy. The patients showed a higher PSA response rate and a longer survival with same degrees of adverse events.Background: Chemotherapy can reduce serum prostate-specific antigen (PSA) levels and relieve pain in some patients with castration-resistant prostate cancer (CRPC). To improve therapeutic efficacy numerous randomized trials have investigated docetaxel-based combination regimens. The present analysis tries to overcome the statistical limitations of the individual trials and investigates the treatment effects in total and in various combination groups. Methods: The Medline, Embase, Cancerlit, and American Society of Clinical Oncology Abstract databases were searched for published randomized placebo-controlled trials evaluating the use of docetaxel-based regimens in patients with CRPC. The outcomes assessed were overall survival, overall response rate, PSA response rate, and adverse effects. Results: Twelve articles (2244 participants) were included in the meta-analysis. The analysis demonstrates a higher PSA response rate from docetaxel-based combinations when compared with docetaxel alone (relative risk [RR] = 1.16; P = .010). The estimated median survival in docetaxel-based combinations was statistically significantly longer than in the docetaxel-alone group (22.0 vs. 18.4 months; P = .037). Grade 3 or 4 neutropenia as well as grade 3 or 4 thromboembolic events were similar in both arms (overall RR, 0.87 [confidence interval (CI) 0.71-1.07]; P = .20 and overall RR 1.52 [0.79 - 2.90]; P = .21, respectively). Conclusion: The analysis of 12 randomized trials provides evidence in favor of docetaxel-based combination chemotherapy for patients with CRPC and good performance status.