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Neoadjuvant Chemotherapy Using Reduced‐Dose Docetaxel Followed by Radical Prostatectomy for Patients With Intermediate and High‐Risk Prostate Cancer: A Single‐Center Study
Author(s) -
Nosov Alexander,
Reva Sergey,
Petrov Sergey,
Mamijev Eldar,
Novikov Roman,
Veliev Evgeniy,
Imkamp Florian,
Tolkach Yuri,
Moiseenko Vladimir
Publication year - 2016
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.23165
Subject(s) - medicine , docetaxel , prostate cancer , prostatectomy , urology , chemotherapy , regimen , androgen deprivation therapy , prostate , oncology , single center , cancer , surgery
BACKGROUND To assess safety, pathologic response rate, and long‐term oncologic outcomes of radical prostatectomy (RP) after neoadjuvant chemotherapy using reduced‐dose docetaxel without androgen‐deprivation therapy in prostate cancer (PCa) patients of intermediate‐ and high‐risk groups. METHODS Forty‐four patients with PCa (PSA > 10 ng/ml, Gleason score 7 or more, or clinical stage cT2c or more) were included with a median follow‐up of 11.4 years after RP. One group (NCT/RP) received neoadjuvant treatment 3‐weekly with docetaxel (36 mg/m 2 for up to six cycles, 21 patients), the other (control) group (RP, 23 patients) received RP only. RESULTS Toxicities were mild with grade 3 events not exceeding 10%. A statistically significant reduction of PSA > 50% post‐chemotherapy was observed in 52.4% cases. Cancer‐specific survival (CSS) was 90% in the NCT/RP group and 60.9% in the RP group ( P = 0.042). The biochemical recurrence‐free survival was 68.5% in the NCT/RP and 37.7% in the RP groups; overall survival was 75.5% and 54.6%, respectively (both P > 0.05). CONCLUSIONS The use of neoadjuvant chemotherapy before RP in a selected regimen and dose represents a safe strategy and results in benefits in CSS. Given the limitations of the study, this concept should be evaluated in large, prospective, controlled studies. Prostate 76: 1345–1352, 2016 . © 2016 Wiley Periodicals, Inc.