Overall Survival of Patients with Castration-Resistant Prostate Cancer Receiving Docetaxel-Prednisolone ; ระยะเวลาการรอดชีวิตของผู้ป่วยมะเร็งต่อมลูกหมากระยะที่ไม่ตอบสนองต่อการยับยั้งฮอร์โมนเพศชายที่ได้รับยาเคมีบำบัดสูตรโดซิแทกเซลและเพรดนิโซโลน

Background: Prostate cancer is prevalent in aging males. If the patient can live longer enough, every patient will suffer from castration resistant prostate cancer (CRPC). The CRPC is the state of disseminated disease which progresses even though the patient has undergone castration. Docetaxel/prednisolone regimen has been established the standard of care for such patients, and can be reimbursed in Thailand since 2011. It is not known whether the policy that provided such an expensive treatment benefited to Thai CRPC patients. We performed the retrospective cohort study of Thai CRPC patients who had attended in Vajira Hospital between January 1, 2011 to December 31, 2015. The primary endpoint was overall survival (OS) among patients who had been treated with docetaxel/prednisolone. Methods: Data from the medical records of CRPC patients treated with docetaxel/prednisolone regimen were analysed with respect to clinical, prostate-specific antigen (PSA) response and overall survival. The data were compared to the results of the TAX 327 study. Results: There were 41 CRPC patients in our cohort. Thirty-seven of them were treated with docetaxel/prednisolone regimen. At the diagnosis of CRPC, the median age of the patients was 74 (IQR 13) and PSA was 127 (IQR 695). The median Gleason score was 8 (IQR 1.54). In case of the patients with PS 0 and 1 and without underlying comorbidities, this regimen was well tolerated. The most common cause of discontinuation was progression of disease. The overall survival was 15 months (IQR 2.78). PSA response rate (according to PCWG) was 67.7%. The median OS of our cohort was less compared to the TAX 327 study; however, our patients was older, had higher PSA and Gleason score. Conclusion: In well-selected CRPC patients, docetaxel/prednisolone regimen is well tolerated and leads to prolonging of survival not much different from the original study. We advocate that such regimen should be beneficial to Thai CRPC patients as well. ; วัตถุประสงค์: ...