RESUMO
PURPOSE: To assess the overall survival (OS) of metastatic hormone-refractory prostate cancer (mHRPC) patients when treated with zoledronic acid (ZOL) in combination with docetaxel-based chemotherapy (docetaxel combined with estramustine or oxaliplatin or gemcitabine). METHODS: A retrospective chart review of mHRPC patients in our clinic was performed. At the time of data collection, 23 patients with mHRPC were identified, of which 15 were still alive at data analysis. Survival data was analyzed through Kaplan-Meier methodology. OS stratification by prostatic specific antigen (PSA) response (50% and 80% decline) and multivariate analysis of prognostic variables were also conducted. RESULTS: 182 cycles of chemotherapy (mean 8.27 cycles, range 1-23) were recorded. Median OS was 26 months (range 5-56; 95% CI: 4.0-48.0). No patient achieved complete response (CR), 5 (21.7%) showed partial response (PR), 2 (8.7%) minor response (MR), 7 (30.4%) stable disease (SD) and 9 (39.1%) progressive disease (PD). Twelve (52.2%) patients exhibited a decrease in PSA levels >50% (9 of 12 >80%). No association of age, PSA response, or tumor response with OS could be demonstrated. The most frequent toxicities were anaemia (52.1%) and neutropenia (26%). CONCLUSION: In our clinical setting, ZOL and docetaxel- containing chemotherapy was a beneficial therapeutic scheme for the patients in terms of safety and survival.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Desoxicitidina/administração & dosagem , Desoxicitidina/efeitos adversos , Desoxicitidina/análogos & derivados , Difosfonatos/administração & dosagem , Difosfonatos/efeitos adversos , Docetaxel , Estramustina/administração & dosagem , Estramustina/efeitos adversos , Humanos , Imidazóis/administração & dosagem , Imidazóis/efeitos adversos , Masculino , Pessoa de Meia-Idade , Neoplasias Hormônio-Dependentes/sangue , Neoplasias Hormônio-Dependentes/tratamento farmacológico , Compostos Organoplatínicos/administração & dosagem , Compostos Organoplatínicos/efeitos adversos , Oxaliplatina , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Taxa de Sobrevida , Taxoides/administração & dosagem , Taxoides/efeitos adversos , Ácido Zoledrônico , GencitabinaRESUMO
Six antimicrobial agents were administered to 48 patients (divided in 6 groups) who underwent prostatectomy. Half of the patients received the antibiotic in a single dose one hour before the operation and the rest in divided doses 24 hours before the operation. The concentration levels in serum and in prostatic tissue were measured for each of the antibiotics and for each mode of administration. The obtained ratios of prostatic tissue to serum concentrations and the relative antimicrobial activity to local pathogens of each agent indicate that the agent of choice for prostatic disease is netilmicin followed by aztreonam, cefuroxime and the ticarcillin-clavulanic acid combination.
