The efficacy and safety of docetaxel chemotherapy in the treatment of localised high-risk prostate cancer: a Meta-analysis / 中华泌尿外科杂志

ABSTRACT

Objective The role of additional docetaxel chemotherapy in the treatment of localised high-risk prostate cancer (PCa) remains a controversy.This meta-analysis aimed to investigate the effect of additional docetaxel chemotherapy on localised high-risk PCa.Methods A computerized search was performed in Pubmed,Embase,Cochrane Library,Web of Science,CBM,CNKI,VIP and Wanfang Data to collect clinical controlled trails on localised high-risk PCa treated with docetaxel chemotherapy from the inception to April 2019.The Review Manager 5.3 software was used to perform meta-analysis of survival data and adverse events.Results Six literatures were enrolled,including 3 187 patients.Compared with the standard treatment (local treatment combined with endocrine therapy) group,the progression-free survival (PFS) was prolonged in the standard treatment plus docetaxel group,and the difference was statistically significant.[hazard ratio (HR) =0.75,95 ％ CI 0.65-0.86,P ＜ 0.01].Patients in the standard treatment plus docetaxel group had longer overall survival (OS) and biochemical recurrence-free survival (BRFS) in comparison with standard treatment group,but the difference was not statistically significant (HR =0.843,95％CI 0.68-1.01,P =0.06;HR =0.86,95％ CI 0.69-1.07,P =0.17).In terms of safety,the incidence of adverse reactions was increased in the standard treatment plus docetaxel group,including the incidence of grade ≥3 neutropenia (RR =44.14,95％ CI 19.15-101.71,P ＜0.01),the incidence of grade ≥ 3 febrile neutropenia (RR =13.4,95 ％ CI 7.93-22.65,P ＜ 0.01) and the incidence of grade ≥ 3 diarrhea (RR =13.43,95 ％ CI 3.21-56.16,P ＜ 0.01).Conclusions Additional docetaxel chemotherapy could significantly improve the PFS in localised high-risk PCa patients.OS and BRFS were prolonged,but the difference was not statistically significant.