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Efficacy of Androgen Deprivation Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer Receiving Docetaxel-Based Chemotherapy

The World Journal of Men′s Health 2020년 38권 2호 p.226 ~ 235
Min Kyung-Chan, 정재욱, 하윤석, 이준녕, 김범수, 김현태, 김태환, 유은상, 권태균, 정성광, Tanaka Masatoshi, Egawa Shin, Kimura Takahiro, 최석환,
소속 상세정보
 ( Min Kyung-Chan ) - Kyungpook National University Chilgok Hospital Department of Urology
정재욱 ( Chung Jae-Wook ) - Kyungpook National University Chilgok Hospital Department of Urology
하윤석 ( Ha Yun-Sok ) - Kyungpook National University Hospital Department of Urology
이준녕 ( Lee Jun-Nyung ) - Kyungpook National University Chilgok Hospital Department of Urology
김범수 ( Kim Bum-Soo ) - Kyungpook National University Hospital Department of Urology
김현태 ( Kim Hyun-Tae ) - Kyungpook National University Chilgok Hospital Department of Urology
김태환 ( Kim Tae-Hwan ) - Kyungpook National University Chilgok Hospital Department of Urology
유은상 ( Yoo Eun-Sang ) - Kyungpook National University Hospital Department of Urology
권태균 ( Kwon Tae-Gyun ) - Kyungpook National University Chilgok Hospital Department of Urology
정성광 ( Chung Sung-Kwang ) - Kyungpook National University Hospital Department of Urology
 ( Tanaka Masatoshi ) - Jikei University School of Medicine Department of Urology
 ( Egawa Shin ) - Jikei University School of Medicine Department of Urology
 ( Kimura Takahiro ) - Jikei University School of Medicine Department of Urology
최석환 ( Choi Seock-Hwan ) - Kyungpook National University Hospital Department of Urology

Abstract


Purpose: The purpose of this study was to determine the comparative effectiveness of androgen deprivation therapy (ADT) combined with docetaxel (DTX)-based chemotherapy in Korean and Japanese castration-resistant prostate cancer (CRPC) patient cohorts.

Materials and Methods: Metastatic CRPC patients who underwent more than three DTX-based chemotherapy cycles in Korea and Japan between 2002 and 2017 were retrospectively analyzed and divided into the DTX-only (DTX, n=30) and combination (DTX+ADT, n=46) groups. Progression-free survival (PFS) was calculated as the time from the start of chemotherapy to the occurrence of either disease progression (prostate-specific antigen [PSA] progression or radiographic progression) or death. The primary end point was PFS and the secondary end point was overall survival (OS).

Results: In the DTX and DTX+ADT groups, the median PFS was 6.0 and 11.0 months (log-rank p=0.053). The multivariate Cox regression analysis revealed that the significant predicting factors of PFS were ADT administration (hazard ratio [HR], 0.478; 95% confidence interval [CI], 0.284?0.804; p=0.005) and number of DTX-based chemotherapy cycles (HR, 0.934; 95% CI, 0.899?0.970; p<0.001). In the DTX and DTX+ADT groups, the median OS was 16.0 and 19.5 months (log-rank p=0.825). Through multiple Cox regression analysis, we found that the significant predicting factors of OS were the PSA nadir level (HR, 1.001; 95% CI, 1.000?1.002; p<0.001) and number of DTX-based chemotherapy cycles (HR, 0.932; 95% CI, 0.876?0.991; p=0.024).

Conclusions: Concurrent DTX-based chemotherapy and ADT may be beneficial compared with DTX-based chemotherapy alone in chemotherapy-naive metastatic CRPC patients in terms of the PFS, but not the OS.

키워드

Antineoplastic hormonal drugs; Docetaxel; Progression-free survival; Prostate cancer

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