Prognostic Factors For Chemotherapy In Patients With Metastatic Castration Resistant Prostate Cancer

Objective: Metastatic Castration resistant prostate cancer(m CRPC)is one of the worldwide malignant tumors which worst seriously affect men’s quality of life and overall survival at present. C linical data of patients that accepted systematic chemotherapy in the hospital are reviewed, we investigated the prognostic factors for patients with m CRPC and provid a comprehensive therapy for patients with advanced prostate cancer.Patients and Methods(1)From September 2008 to April 2013, 460 patients with prostate cancer in the hospital were reviewed. 237 cases were found with distant metasta ses according to the results of imageological examination.Among these patients, Prostate specific antigen(PSA) was redused in 109 cases and then increased after the treatment about 18-24 months. Those patients who were unfavorable chemotherapy and those who refused to chemotherapy were excluded. As a result, 51 cases whose testosterone were less than 50ng/dl(1.7nmol/l) were included in this study. These 51 cases with m CRPC wre scheduled for systematic chemotherapy with docetaxel and prednisone rather tha n second- line endocrinal or other treatment. Prognostic factors for systematic chemotherapy such as Eastern Cooperative O ncology Group(ECOG), Prostate specific antigen doubling time(PSADT), hormone sensitive time, Gleason scores, initial prostate specific antigen(PSA) and pre-chemo blood routin test were analyzed with purpose of seeking therapeutic and prognostic factors for m C RPC patients.(2) SPSS22.0 was used to perform the statistical analysis. Univariate analysis was used to evaluate the prognostic factors for m C RPC patients. COX regression multivariate analysis was assessed for factors with statistical probability of p < 0.05. Significance Testing was used for OS based on Log-rank survival curve. Kaplan-Meier analysis was used to analysis the survival function.Results(1) From docetaxel treatment to the last follow- up or death, 24 of 51 patients died while 27 survived. The average cycle of chemotherapy was 6. Serious adverse reactions were not found. Median survival time is 22 months. According to the log-rank survival curve,cumulative survival rate of patients in 10, 15, 20 months was nearly 95%, 90% and 70%, respectively.(2) Univariate analysis suggest that pre-chemo PSADT, initial PSA, hemoglobin, hormone sensitive time, Gleason scores, and ECOG were independent therapeutic and prognostic factors for m CRPC. The age at diagnosis of prostate cancer、the age at first chemotherapy and white blood cells were irrelevant to prognosis.(3) COX regression multivariate analysis suggested that pre-chemo PSADT, initial PSA, hemoglobin, hormone sensitive time, Gleason scores were independent therapeutic and prognostic factors fo r m C RPC.Conclusion(1) MCRPC patients with docetaxel and prednisone therapy is safety and effective.(2)Pre-chemo PSADT, initial PSA, hemoglobin, hormone sensitive time, Gleason scores was independent therapeutic and prognostic factors for m C RPC.(3) ECOG score、the age at diagnosis of prostate cancer、the age at first chemotherapy and white blood cells may not be therapeutic and prognostic factors for m CRPC.