Clinical outcomes by relative docetaxel dose and dose intensity as chemotherapy for Japanese patients with castration-resistant prostate cancer: a retrospective multi-institutional collaborative study
Clinical outcomes by relative docetaxel dose and dose intensity as chemotherapy for Japanese patients with castration-resistant prostate cancer: a retrospective multi-institutional collaborative study
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DOI：
10.1007/s10147-012-0510-9
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发表时间：
2014-02-01
影响因子：
3.3
通讯作者：
Ichikawa, Tomohiko
中科院分区：
文献类型：
--
作者：
Kamiya, Naoto;Suzuki, Hiroyoshi;Ichikawa, Tomohiko
本研究的目的是回顾性研究多西紫杉醇（DOC）作为化疗药物治疗日本去势抵抗性前列腺癌（CRPC）患者的相对剂量和剂量强度的临床结果。方法选取2005 ~ 2011年14家医院接受4个疗程以上DOC化疗的CRPC患者145例。患者被分为两组，接受较高或较低剂量（mg/m(2)）或剂量强度（mg/m(2)/周）。确定两组治疗结果和不良事件（ae）的差异。此外，通过单因素和多因素分析确定了预测这些患者癌症特异性生存（CSS）的预后因素。结果总患者组平均经历11.2 +/- 7.4DOC周期，治疗后平均CSS为15.6 +/- 10.1个月。高剂量组前列腺特异性抗原（PSA）反应优于低剂量组。但两组间DOC化疗后预后差异无统计学意义。高剂量组白细胞减少和中性粒细胞减少发生率较高。血清生物标志物（包括PSA、乳酸脱氢酶和碱性磷酸酶）、化疗开始时血红蛋白水平和疼痛的存在，以及一线激素治疗时PSA的最低点水平，都是CSS的重要预测因素。结论：在日本人群中，相对低剂量的DOC化疗对CRPC患者的CSS没有有害影响，尽管PSA反应降低，但与接受高剂量化疗的患者相比，ae的发生率较低。
Background The aim of this study was to retrospectively investigate clinical outcomes by relative dose and dose intensity of docetaxel (DOC) as chemotherapy for Japanese patients with castration-resistant prostate cancer (CRPC).Methods A total of 145 CRPC patients who received more than 4 courses of DOC chemotherapy at 14 hospitals between 2005 and 2011 were enrolled. Patients were divided into two groups-those receiving a higher or lower dose (mg/m(2)) or dose intensity (mg/m(2)/week). Differences between the groups regarding treatment outcomes and adverse events (AEs) were determined. Additionally, prognostic factors predictive of cancer-specific survival (CSS) in these patients were identified by both univariate and multivariate analysis.Results The total patient group underwent a mean of 11.2 +/- 7.4DOC cycles, and the mean CSS after therapy was 15.6 +/- 10.1 months. The higher-dose group had a better prostate-specific antigen (PSA) response than the lower-dose group. However, there was no significant difference between the groups in prognosis after DOC chemotherapy. Leukopenia and neutropenia were observed more frequently in the higher-dose group. Serum biomarkers (including PSA, lactate dehydrogenase and alkaline phosphatase), hemoglobin levels and presence of pain at initiation of chemotherapy, as well as the PSA nadir level on first-line hormone therapy, all were significant predictors of CSS.Conclusions In the Japanese population, relatively low-dose DOC chemotherapy had no deleterious effect on the CSS of CRPC patients, and a lower incidence of AEs occurred, in spite of a diminished PSA response compared with those receiving a higher dose.