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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제57권 제5호
발행연도
2016.1
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1,070 - 1,078 (9page)

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Purpose: Docetaxel-based chemotherapy (DTX) improves overall survival (OS) of men with metastatic castration-resistant prostatecancer (mCRPC). Considering the potential existence of androgen receptors that remain active at this stage, we aimed to assessthe impact of the combined use of androgen deprivation therapy (ADT) with DTX for mCRPC. Materials and Methods: We performed a single-institutional retrospective analysis of patients with mCRPC who received eitherDTX alone (DTX group, n=21) or concurrent DTX and ADT (DTX+ADT group, n=26) between August 2006 and February 2014. All patients received DTX doses of 75 mg/m2 every three weeks for at least three cycles. In the DTX+ADT group, all patients usedluteinizing hormone releasing hormone agonist continuously as a concurrent ADT. Results: The median follow-up period was 24.0 months (interquartile range 12.0–37.0) for the entire cohort. The median radiographicprogression-free survival (rPFS) was 9.0 months and 6.0 months in the DTX+ADT and DTX groups, respectively (log-rankp=0.036). On multivariable Cox regression analysis, concurrent administration of ADT was the only significant predictor of rPFS[hazard ratio (HR)=0.525, 95% confidence intervals (CI) 0.284–0.970, p=0.040]. The median OS was 42.0 and 38.0 months in theDTX+ADT and DTX groups, respectively (log-rank p=0.796). On multivariable analysis, hemoglobin level at the time of DTX initiationwas associated with OS (HR=0.532, 95% CI 0.381–0.744, p<0.001). Conclusion: In chemotherapy-naive patients with mCRPC, the combined use of ADT with DTX improved rPFS. Our result suggeststhat the concurrent administration of ADT and DTX is superior to DTX alone.

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