Affiliation:
1. Associate Professsor, Department of Surgery, MLB Medical College Jhansi (U.P).
2. Professor, Department of Urology, PGIMER & Dr RMLHospital, New Delhi
Abstract
Introduction: Studies on the effects of chemotherapy in Indian Castration-Resistant Prostate Cancer (CRPC) patients are very limited and world
data is inconsistent. The purpose of the present study is to assess the effects of Docetaxel therapy in CRPC in Indian patients in terms of survival
benet, both progression-free survival, and overall survival. This study also analyzes the effects of various factors on the survival of CRPC
patients.
Methodology: This is a single institutional prospective observational study. CRPC patients were treated with Docetaxel and followed till death as
the primary endpoint or till the end of the study. Survivals were calculated with the Kaplan Meier method. Factors affecting survival were analyzed
with univariate and multivariate analysis by log-rank t-test and Cox proportion hazard regression analysis.
Result: Out of enrolled 101 patients, 78 were treated with Docetaxel. A decline in PSA (>50% reduction) was observed in 61.54%. Radiological
response of regression noted in 40 % Nuclear Bone Scan and 19.23% CT/MRI by RECIST criteria. Progression-free survival and overall survival
with Docetaxel (n=78) were 11.8 and 21 months respectively. Hemoglobin less than 11 gm%, Alkaline phosphatase more than 115 IU/dl, PSAmore
than 14 ng/ml, Gleason score more than 7 and duration from diagnosis of carcinoma prostate to CRPC less than 24 months, the number of
chemotherapy cycles less than 6 were all found to be signicantly associated with poor overall survival in univariate analysis while only
Hemoglobin (P=0.0159) showed an independent association with overall survival in multivariate analysis.
Conclusion: Overall and progression-free survival of CRPC patients with Docetaxel is 21 & 11.8 months respectively. Hemoglobin, Alkaline
phosphatase, PSA, Gleason score, Docetaxel cycle, and duration from diagnosis of carcinoma prostate to CRPC were found to be signicantly
associated with poor overall survival.
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