A Single-center Real-world Study Of Docetaxel For Metastatic Prostate Cancer

Objective: To evaluate the short-term efficacy and safety of docetaxel plus hormone therapy for metastatic prostate cancer.Methods: From April 2016 to April 2019,204 cases with bone metastatic prostate cancer in the Second Hospital of Tianjin Medical University were analyzed retrospectively.97 patients responded to hormone therapy including 92 cases with high-burden metastasis and 5 cases with low-burden metastasis.Average age was 70y(range 42-87).Median prostate specific antigen(PSA)was 74.1ng/ml(range 11.0-145.0).107 patients were with resistance to hormone therapy.Average age was 73y(range 56-83).Median PSA was 84.5ng/ml(range 12.4-490.2).All patients received continuous hormone therapy combined with docetaxel(at a dose of 75 mg per square meter of body-surface area every 3w,plus prednisone 5 mg twice a day).PSA response rate,PSA progression-free survival(PSA-PFS),numerical rating scales(NRS)score,pain relief,and adverse events were analyzed.Results: Median follow-up time was 7m(range 4-16).For patients with metastatic hormone sensitive prostate cancer(m HSPC),6(6.2%)only received 1-2 cycles of chemotherapy due to different reasons.Others received 3-6 cycles(average 4.7).Of patients who received ≥3 cycles,PSA response was effective in 87 cases(95.6%).1-year PSA-PFS rate was 78.6%.Average NRS score declined from 3.9 to 3.0.Rate of pain relief was 19.8%.For patients with metastatic castration-resistant prostate cancer(m CRPC),9(8.4%)only received 1-2 cycles of chemotherapy.Others received 3-14 cycles(average 5.6).Of patients who received ≥3 cycles,PSA response was effective in 66 cases(67.3%).Median PSA-PFS was 9.0m(8.1-9.9).Average NRS score declined from 5.6 to 4.4.Rate of pain relief was 35.7%.Subgroup analysis showed a significant correlation between PSA level and PSA response rate for patients with m CRPC.Age or Gleason score was not significantly correlated to PSA response rate.For patients with m HSPC,rate of grade 3 or 4 neutropenia was 17.5%(17 cases).Nausea and vomit occurred in 27 patients(27.8%).25 patients(25.8%)had fatigue.For patients with m CRPC,rate of grade 3 or 4 neutropenia was 22.4%(24 cases).Nausea and vomit occurred in 34 patients(31.8%).26 patients(24.3%) had fatigue.Allergic reaction,sensory neuropathy toxicity and edema were less frequent.Conclusion: Short-term efficacy of docetaxel plus hormone therapy was confirmed for metastatic prostate cancer and adverse events were tolerable.