Meta-analysis Of Docetaxel Combined With Androgen Deprivation Therapy Versus Androgen Deprivation Therapy In Patients For Treatment Of Castration-resistant Prostate Cancer

Objective: To assess the effectiveness and safety of docetaxel combined with androgen deprivation therapy versus androgen deprivation therapy(ADT)for treatment of castration-resistant prostate cancer.Methods: Literature about the treatment of castration-resistant prostate cancer by docetaxel combined with androgen deprivation therapy OR androgen deprivation therapy(ADT)(published between 1993.1 and 2020.9)were searched and collected.Methodological quality of the literature was assessed using the Cochrane system evaluation methodology,and meta-analysis was performed using RevMan 5.3 Software.Results: Eventually,four randomized controlled trials(RCT)including1298 patients in the docetaxel combined with androgen deprivation therapy group and 1199 patients in the ADT alone group were enrolled in this study.Meta-analysis results indicated that the cPFS,bPFS and OS were significantly superior in patients who underwent docetaxel combined with androgen deprivation therapy compared with those who underwent androgen deprivation therapy(P<0.001).Increased overall survival was shown in the combination therapy group of the high-volume disease patients(P = 0.0003).However,there was no significant difference in postoperative complications.Compared with docetaxel combined with androgen deprivation therapy group and ADT alone group complications,significant differences were shown in neutropenia,febrile neutropenia and fatigue.Conclusions: For castration-resistant prostate cancer patients,the co mbination of docetaxel and ADT is a more effective and safe therapeuti c schedule.