Articles

Prognostic and Predictive Factors in Patients with Androgen-Independent Prostate Cancer Treated with Docetaxel and Estramustine: A Single Institution Experience

By: Aristotle Bamiasa lowast , George Bozasa, Nikolaos Antonioub, Iraklis Pouliasc, Harilaos Katsifotisd, Andreas Skolarikose, Dionysios Mitropoulose, Christos Alamanise, Gerassimos Alivizatose, Haralambos Deliveliotise and Meletios A. Dimopoulosa

Published online: 01 February 2008

Keywords: Chemotherapy, Docetaxel, Estramustine, Prognosis, Prostate cancer

Abstract Full Text Full Text PDF (455 KB)

Abstract

Objectives

To investigate potential prognostic and predictive factors in patients with androgen-independent prostate cancer (AIPC) treated with docetaxel chemotherapy.

Methods

This analysis included 94 consecutive AIPC patients who were treated between March 2001 and May 2006 with biweekly docetaxel 45mg/m2 (day 2) and estramustine 140mg three dimes daily (days 1–3).

Results

Prostate-specific antigen (PSA) responses were observed in 45 of 84 evaluable patients (53%), whereas objective responses were observed in 16 of 40 patients with measurable disease (40%). Median survival (OS) was 16.2 mo (95% confidence interval [CI], 12.9–19.4) and median time to PSA progression (TTP) 5.0 mo (95%CI, 3.6–7.1). OS was independently associated with pain score baseline PSA and weight loss. Patients with only extraosseous disease had higher PSA response rate (87% vs. 49%, p=0.014) and superior TTP compared with patients with bone metastases with or without extraosseous disease (7.3 vs. 4.3 vs. 4 mo, p=0.002). Concurrent bone and extraosseous metastases were associated with worse prognosis compared with each site alone (median OS: 12.3 vs.19 vs.18.3 mo, p=0.007).

Conclusions

Among patients with AIPC treated with biweekly docetaxel and estramustine, baseline PSA >100, existence of pain, weight loss, and simultaneous extraosseous and bone disease were associated with worse prognosis. Extraosseous metastases seem to be more sensitive than bone disease to this chemotherapy.

Take Home Message

PSA levels, pain score, and weight loss were independently associated with survival in 94 patients with androgen-independent prostate cancer treated with docetaxel/estramustine. Extraosseous disease was associated with better PSA response and longer TTP, while simultaneous bone and extraosseous metastases were a predictor of poor outcome.

Keywords: Chemotherapy, Docetaxel, Estramustine, Prognosis, Prostate cancer.

Footnotes

a Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece

b Amalia Fleming Hospital, Athens, Greece

c Erythros Stavros Hospital, Athens, Greece

d Polykliniki Athinon, Athens, Greece

e Department of Urology, University of Athens, School of Medicine, Athens, Greece

lowast Corresponding author. 31 Komninon St, Haidari, Athens 124 62, Greece. Tel. +30 210 3381546; Fax: +30 210 3381511.