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Survival Outcomes of Concurrent Treatment with Docetaxel and Androgen Deprivation Therapy in Metastatic Castration-Resistant Prostate Cancer

 Ho Seong Jang  ;  Kyo Chul Koo  ;  Kang Su Cho  ;  Byung Ha Chung 
 Yonsei Medical Journal, Vol.57(5) : 1070-1078, 2016 
Journal Title
 Yonsei Medical Journal 
Issue Date
Adenocarcinoma/blood ; Adenocarcinoma/drug therapy* ; Adenocarcinoma/secondary ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Disease-Free Survival ; Gonadotropin-Releasing Hormone/administration & dosage ; Gonadotropin-Releasing Hormone/agonists ; Hemoglobins/metabolism ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms, Castration-Resistant/blood ; Prostatic Neoplasms, Castration-Resistant/drug therapy* ; Prostatic Neoplasms, Castration-Resistant/pathology ; Retrospective Studies ; Survival Rate ; Taxoids/administration & dosage
Prostatic neoplasms, castration-resistant ; disease-free survival ; docetaxel ; drug therapy, combination ; gonadotropin-releasing hormone ; neoplasm metastasis
PURPOSE: Docetaxel-based chemotherapy (DTX) improves overall survival (OS) of men with metastatic castration-resistant prostate cancer (mCRPC). Considering the potential existence of androgen receptors that remain active at this stage, we aimed to assess the impact of the combined use of androgen deprivation therapy (ADT) with DTX for mCRPC. MATERIALS AND METHODS: We performed a single-institutional retrospective analysis of patients with mCRPC who received either DTX alone (DTX group, n=21) or concurrent DTX and ADT (DTX+ADT group, n=26) between August 2006 and February 2014. All patients received DTX doses of 75 mg/m² every three weeks for at least three cycles. In the DTX+ADT group, all patients used luteinizing hormone releasing hormone agonist continuously as a concurrent ADT. RESULTS: The median follow-up period was 24.0 months (interquartile range 12.0-37.0) for the entire cohort. The median radiographic progression-free survival (rPFS) was 9.0 months and 6.0 months in the DTX+ADT and DTX groups, respectively (log-rank p=0.036). On multivariable Cox regression analysis, concurrent administration of ADT was the only significant predictor of rPFS [hazard ratio (HR)=0.525, 95% confidence intervals (CI) 0.284-0.970, p=0.040]. The median OS was 42.0 and 38.0 months in the DTX+ADT and DTX groups, respectively (log-rank p=0.796). On multivariable analysis, hemoglobin level at the time of DTX initiation was associated with OS (HR=0.532, 95% CI 0.381-0.744, p<0.001). CONCLUSION: In chemotherapy-naive patients with mCRPC, the combined use of ADT with DTX improved rPFS. Our result suggests that the concurrent administration of ADT and DTX is superior to DTX alone.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
구교철(Koo, Kyo Chul) ORCID logo https://orcid.org/0000-0001-7303-6256
장호성(Jang, Ho Seong)
정병하(Chung, Byung Ha) ORCID logo https://orcid.org/0000-0001-9817-3660
조강수(Cho, Kang Su) ORCID logo https://orcid.org/0000-0002-3500-8833
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