摘要
Whether continuous docetaxel （DTX） chemotherapy offers an advantage over intermittent therapy for castration-resistant prostate cancer （CRPC） is unknown. In this study, we evaluated the efficacy, toxicity and quality of life （QoL） of intermittent tri-weekly DTX with bicalutamide in CRPC. Forty-two patients （group A） with CRPC were enrolled. The patients received intravenous DTX （75 mg m^-2） once tri-weekly with oral bicalutamide （50 mg） once daily. Patients had a DTX holiday when the prostate-specific antigen （PSA） level declined ≥ 50%. DTX was restarted in patients with a PSA increase ≥ 25%. Sixty patients （group B） who had matching characteristics and had continuously received DTX without bicalutamide for 10-12 cycles were also enrolled. There were no statistically significant differences in progression-free survival （8 months vs. 9 months, P=0.866） or overall survival （19 months vs. 21 months, P=0.753） between groups A and B; however, the proportions of patients in group A with all grades of neutropenia （33% vs. 58%, P=0.013） and nausea/vomiting （11% vs. 29%, P=0.024） were significantly less compared to group B. A significant improvement in the global health and fatigue scores was recorded for group A post-chemotherapy compared to pre-chemotherapy （P〈0.05）. The fatigue, nausea/ vomiting and appetite loss scores in group B were increased post-chemotherapy compared to pre-chemotherapy （P〈0.05）. In conclusion, intermittent tri-weekly DTX plus bicalutamide is well tolerated and has the potential to achieve comparable disease control with an improvement in QoL for oatients with CRPC.
Whether continuous docetaxel （DTX） chemotherapy offers an advantage over intermittent therapy for castration-resistant prostate cancer （CRPC） is unknown. In this study, we evaluated the efficacy, toxicity and quality of life （QoL） of intermittent tri-weekly DTX with bicalutamide in CRPC. Forty-two patients （group A） with CRPC were enrolled. The patients received intravenous DTX （75 mg m^-2） once tri-weekly with oral bicalutamide （50 mg） once daily. Patients had a DTX holiday when the prostate-specific antigen （PSA） level declined ≥ 50%. DTX was restarted in patients with a PSA increase ≥ 25%. Sixty patients （group B） who had matching characteristics and had continuously received DTX without bicalutamide for 10-12 cycles were also enrolled. There were no statistically significant differences in progression-free survival （8 months vs. 9 months, P=0.866） or overall survival （19 months vs. 21 months, P=0.753） between groups A and B; however, the proportions of patients in group A with all grades of neutropenia （33% vs. 58%, P=0.013） and nausea/vomiting （11% vs. 29%, P=0.024） were significantly less compared to group B. A significant improvement in the global health and fatigue scores was recorded for group A post-chemotherapy compared to pre-chemotherapy （P〈0.05）. The fatigue, nausea/ vomiting and appetite loss scores in group B were increased post-chemotherapy compared to pre-chemotherapy （P〈0.05）. In conclusion, intermittent tri-weekly DTX plus bicalutamide is well tolerated and has the potential to achieve comparable disease control with an improvement in QoL for oatients with CRPC.
