Real-world uptake, safety profile and outcomes of docetaxel in newly diagnosed metastatic prostate cancer
Real-world uptake, safety profile and outcomes of docetaxel in newly diagnosed metastatic prostate cancer
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DOI：
10.1111/bju.14025
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发表时间：
2018-02-01
影响因子：
4.5
通讯作者：
MacLeod, Nicholas
中科院分区：
文献类型：
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作者：
Rulach, Robert J.;Mckay, Stephen;MacLeod, Nicholas
ObjectivesTo探讨多西他赛化疗的吸收，安全性和有效性在未经化疗的转移性前列腺癌（MPC）在第一年的临床试验之外的使用。患者和MethodsPatients在苏格兰癌症网络与新诊断的MPC西确定从区域多学科小组会议和他们的治疗细节收集电子病历。发热性中性粒细胞减少症，住院，进展时间，总生存率进行了比较，这些患者接受多西他赛和雄激素剥夺治疗（ADT），或ADT单独使用生存analysis.ResultsOf 270名合格的患者，103多西他赛（38.1%）。35例患者（34%）住院，17例发热性中性粒细胞减少症发作（16.5%）。2例患者（1.9%）在化疗后30天内死亡。与多西他赛组相比，接受ADT单药治疗的患者进展风险增加（风险比[HR] 2.03，95%置信区间[CI] 1.27-3.25;对数秩检验，P = 0.002），死亡风险增加（HR 5.88，95% CI：2.52-13.72;对数秩检验，P = 0.001）。发热性中性粒细胞减少症的风险是9倍，如果化疗是在3周内开始ADT启动（95%CI：1.22-77.72; P = 0.032）。结论多西他赛化疗在化疗初治的mPC有显着的毒性，但有一个类似的影响，进展时间和总生存率在随机试验中看到。化疗应在ADT后>= 3周开始。
ObjectivesTo investigate the uptake, safety and efficacy of docetaxel chemotherapy in hormone-naive metastatic prostate cancer (mPC) in the first year of use outside of a clinical trial.Patients and MethodsPatients in the West of Scotland Cancer Network with newly diagnosed mPC were identified from the regional multidisciplinary team meetings and their treatment details were collected from electronic patient records. The rate of febrile neutropenia, hospitalisations, time to progression, and overall survival were compared between those patients who received docetaxel and androgen-deprivation therapy (ADT), or ADT alone using survival analysis.ResultsOf the 270 eligible patients, 103 received docetaxel (38.1%). 35 patients (34%) were hospitalised and there were 17 episodes of febrile neutropenia (16.5%). Two patients (1.9%) died within 30 days of chemotherapy. Patients who received ADT alone had an increased risk of progression (hazard ratio [HR] 2.03, 95% confidence interval [CI] 1.27-3.25; log-rank test, P = 0.002) and had an increased risk of death (HR 5.88, 95% CI: 2.52-13.72; log-rank test, P = 0.001) compared to the docetaxel group. The risk of febrile neutropenia was nine-times greater if chemotherapy was started within 3 weeks of ADT initiation (95% CI: 1.22-77.72; P = 0.032).ConclusionDocetaxel chemotherapy in hormone-naive mPC has significant toxicities, but has a similar effect on time to progression and overall survival as seen in randomised trials. Chemotherapy should be started at >= 3 weeks after ADT.