959 FEASIBILITY OF BIOCHEMICAL MODULATION CHEMOTHERAPY WITH UFT, CISPLATIN, AND DEXAMETHASONE FOR DOCETAXEL-REFRACTORY PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced (III)1 Apr 2013959 FEASIBILITY OF BIOCHEMICAL MODULATION CHEMOTHERAPY WITH UFT, CISPLATIN, AND DEXAMETHASONE FOR DOCETAXEL-REFRACTORY PROSTATE CANCER Katsuhiro Fukuta, Hiromichi Naruyama, Masahito Hirose, Hiroki Kubota, Noriyasu Kawai, Keiichi Tozawa, Kenjiro Kohri, and Kenjiro Kohri Katsuhiro FukutaKatsuhiro Fukuta yatomi, Japan More articles by this author , Hiromichi NaruyamaHiromichi Naruyama yatomi, Japan More articles by this author , Masahito HiroseMasahito Hirose yatomi, Japan More articles by this author , Hiroki KubotaHiroki Kubota yatomi, Japan More articles by this author , Noriyasu KawaiNoriyasu Kawai nagoya, Japan More articles by this author , Keiichi TozawaKeiichi Tozawa nagoya, Japan More articles by this author , Kenjiro KohriKenjiro Kohri nagoya, Japan More articles by this author , and Kenjiro KohriKenjiro Kohri nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.540AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Docetaxel-based systemic chemotherapy has been shown to be useful for the management of castration-resistant prostate cancer (CRPC). However, reports on drug therapy for docetaxel-refractory prostate cancer are scarce. We evaluated the effectiveness of UFT (a prodrug of 5-fluorouracil [5-FU]), cisplatin, plus dexamethasone in patients with docetaxel-refractory prostate cancer. METHODS Fifty-six patients with CRPC whose serum prostate-specific antigen (PSA) levels had increased on 3 consecutive measurements during docetaxel-based treatment were included in the analysis. Twenty-five patients received oral UFT and dexamethasone plus intravenous cisplatin (UFT-P therapy) and control group (thirty-five patients) were continued docetaxel therapy. PSA levels were measured once a month to evaluate the treatment response. UFT-P therapy related adverse events and overall survival were also assessed. RESULTS The average age was 72.4 years (range, 51-86 years). The mean initial PSA was 720 ng/ml (range, 1.84-9700). Forty-two patients had bone metastases (UFT group had twenty patients, and control group had thirty-five patients) and sixteen patients had lymph node metastases at the start of therapy. The previous treatment was full extraction in fifteen patients and radiotherapy in six patients. The mean observation periods was 592 days (range, 65-1380 days). During UFT-P therapy, PSA levels decreased in 14 of 25 patients (56%). PSA doubling time (PSADT) decreased in 7 of 11 patients, although their PSA levels were increasing. Including these latter patients, the response rate to UFT-P therapy was 84% (21 of 25 patients). The median survival of UFT-P group and control group (docetaxel continued) was 34 and 21 months, respectively. The median time to PSA progression of UFT-P group and control group were 14 and 6 months, respectively. The adverse events of UFT-P therapy were mild diarrhea (20%), general fatigue (100%), and anorexia (44%). However there were not pancytopenia, and adverse events were all grade 1. Treatment by UFT-P could be continued in all patients. Tumor shrinkage during UFT-P therapy was minimal on imaging studies, although hydronephrosis with lymph node metastasis improved in one patient. CONCLUSIONS Our results suggest that UFT-P therapy is effective against docetaxel-refractoly prostate cancer, with minimal adverse events. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e393 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katsuhiro Fukuta yatomi, Japan More articles by this author Hiromichi Naruyama yatomi, Japan More articles by this author Masahito Hirose yatomi, Japan More articles by this author Hiroki Kubota yatomi, Japan More articles by this author Noriyasu Kawai nagoya, Japan More articles by this author Keiichi Tozawa nagoya, Japan More articles by this author Kenjiro Kohri nagoya, Japan More articles by this author Kenjiro Kohri nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...