Docetaxel plus prednisone versus mitoxantrone plus prednisone for metastatic hormone-refractory prostate cancer in chinese patients:experience of a single center / 中国癌症杂志

ABSTRACT

Background and purpose:Chemotherapy with docetaxel has become the first line treatment for hormone refractory prostate cancer.To preliminarily investigate the efficacy of docetaxel plus prednisone and mitoxantrone plus prednisone for treating metastatic hormone-refractory prostate cancer and to further evaluate its adverse events in Chinese patients. Methods:83 patients with metastatic hormone-refractory prostate cancer were candidates for the trial and given a combination of docetaxel 75 mg/m2 intravenously on d 1 or mitoxantrone 12 mg/m2 on day 1 plus prednisone 5 mg twice daily on d 1~21, 21 days a cycle. Serum PSA level, relief of bone pain, myelosuppression, and vomiting were recorded and calculated.Results:Docetaxel plus prednisone were administered to 44 patients, 13.6% (6/44) of them got a complete response; 29.5% (13/44) achieved a partial response; 29.5% (13/44) had stable disease; and 27.3% (12/44) progressed. The average time to PSA progression was 37.8 weeks (12~101 weeks) in the responsive and stable disease patients. The 12 patients with progressive disease were given MP as a salvage therapy, and 16.7% (2/12) achieved a partial response, 25.0% (3/12) had stable disease. Only 2 patients died of disease aggravation. Mitoxantrone plus prednisone were given to 39 patients, and 7.7% (3/39) of them got a complete response; 25.6% (10/39) achieved a partial response; 25.6% (10/39) had a stable disease; and 41.0% (16/39) of patients progressed. The mean time to PSA progression was 25.3 weeks (8~61 weeks) in the responsive and stable disease patients. The 14 patients with progressive disease were administered DP as a salvage therapy, and 7.1% (1/14) achieved a complete response, 35.7% (5/14) got a partial response, 21.4% (3/14) had stable disease and from the new baseline. Four patients died at the last follow-up.Conclusions:In Chinese patients, docetaxel plus prednisone is better than mitoxantrone plus prednisone in PSA response rate and PSA control, but there occurs a bit more toxicity. When the tumor is resistant to one regimen, the other might be still effective in controlling the disease from progression.