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A phase III trial of docetaxel-estramustine in high-risk localised prostate cancer: a planned analysis of response, toxicity and quality of life in the GETUG 12 trial.
Eur J Cancer ; 48(2): 209-17, 2012 Jan.
Article en En | MEDLINE | ID: mdl-22119204
AIM: To assess docetaxel-estramustine in patients with localised high-risk prostate cancer. PATIENTS AND METHODS: After staging pelvic lymph node dissection, patients with high-risk prostate cancer randomly received androgen deprivation therapy (ADT) (3 years)+DE (4 cycles of docetaxel 70 mg/m(2)/3 weeks+estramustine 10mg/kg/dd1-5) or ADT alone. Local therapy was administered at 3 months. RESULTS: Four hundred and thirteen patients were accrued: T3-T4 (67%), Gleason score ~8 (42%), PSA >20 ng/mL (59%), pN+ (29%). In the chemotherapy arm, 94% of patients received the planned four cycles of docetaxel. Local treatment consisted of radiotherapy in 358 patients (87%) (median dose 74 Gy in both arms). ADT was given for 36 months in both arms. A PSA response (PSA ~0.2 ng/mL after 3 months of treatment) was obtained in 34% and 15% in the ADT+DE arm and in the ADT arm, respectively (p<0.0001). Febrile neutropenia occurred in only 2%. Moderate to severe hot flashes occurred less often in the ADT+DE arm (2% versus 22%; p<0.001). There was no toxicity-related death, no secondary leukaemia, and no excess second cancers. Chemotherapy had a negative impact on quality of life (global health status, p = 0.01; fatigue, p = 0.003; role functioning, p = 0.003; social functioning, p = 0.006) at 3 months but this effect disappeared at 1 year. CONCLUSION: Docetaxel-estramustine can be combined safely with standard therapy in high-risk prostate cancer, with a promising PSA response rate and no negative impact on quality of life after 1 year. Long-term follow-up is required to assess the impact on relapse and survival.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Calidad de Vida / Adenocarcinoma / Protocolos de Quimioterapia Combinada Antineoplásica / Antineoplásicos Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Aged / Humans / Male / Middle aged Idioma: En Revista: Eur J Cancer Año: 2012 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Calidad de Vida / Adenocarcinoma / Protocolos de Quimioterapia Combinada Antineoplásica / Antineoplásicos Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Aged / Humans / Male / Middle aged Idioma: En Revista: Eur J Cancer Año: 2012 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido