Chemotherapy in patients with hormone resistant prostate cancer: analysis of benefits and efficacy at a public hospital of Brazil
Purpose: Chemotherapy with docetaxel in hormone resistant prostate cancer improves overall survival (OS); we evaluated patients of a general public hospital in Santo André, SP, Brazil, treated with docetaxel as first line chemotherapy and afterwards with second line chemotherapy based on mitoxantrone. Objectives: To identify the effects of chemotherapy in Progression Free Survival (PFS) and Overall Survival (OS) of first and second line chemotherapy treatments. Materials and Methods: We reviewed the records for 49 patients who received chemotherapy in the setting of disease progression despite castration. We evaluated PFS and OS in first line setting, and pain control and PSA levels in second line. Results: Among 49 patients who received chemotherapy with docetaxel, the median PFS was 7 months and OS was 15 months. Only 10 patients received second line chemotherapy, 8 of them with mitoxantrone. It was not possible to evaluate OS or PFS for those patients, although 50% of them seemed to have benefitted in controlling their pain and none of them heve reduced their PSA levels. By Cox regression, only presence of visceral disease and Gleason above 8 correlated significantly with PFS, whereas no correlations were found with OS. Conclusion: In our hands Docetaxel as the first line chemotherapy option for patients with castrate resistant prostate cancer produced OS results similar to the literature. Without the use of new drugs that are not available in our public sector, the benefits of second line chemotherapy are uncertain.
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