Neoadjuvant chemotherapy using reduced-dose docetaxel followed by radical prostatectomy for patients with intermediate and high-risk prostate cancer: a single-center study.

BACKGROUND - To assess safety, pathologic response rate, and long-term oncologic outcomes of radical prostatectomy (RP) after neoadjuvant chemotherapy using reduced-dose docetaxel without androgen-deprivation therapy in prostate cancer (PCa) patients of intermediate- and high-risk groups.

METHODS - Forty-four patients with PCa (PSA > 10 ng/ml, Gleason score 7 or more, or clinical stage cT2c or more) were included with a median follow-up of 11. 4 years after RP. One group (NCT/RP) received neoadjuvant treatment 3-weekly with docetaxel (36 mg/m(2) for up to six cycles, 21 patients), the other (control) group (RP, 23 patients) received RP only.

RESULTS - Toxicities were mild with grade 3 events not exceeding 10%. A statistically significant reduction of PSA > 50% post-chemotherapy was observed in 52. 4% cases. Cancer-specific survival (CSS) was 90% in the NCT/RP group and 60. 9% in the RP group (P = 0. 042). The biochemical recurrence-free survival was 68. 5% in the NCT/RP and 37. 7% in the RP groups; overall survival was 75. 5% and 54. 6%, respectively (both P > 0. 05).

CONCLUSIONS - The use of neoadjuvant chemotherapy before RP in a selected regimen and dose represents a safe strategy and results in benefits in CSS. Given the limitations of the study, this concept should be evaluated in large, prospective, controlled studies. Prostate. © 2016 Wiley Periodicals, Inc.

The Prostate. 2016 Feb 11 [Epub ahead of print]

Alexander Nosov, Sergey Reva, Sergey Petrov, Eldar Mamijev, Roman Novikov, Florian Imkamp, Yuri Tolkach, Vladimir Moiseenko

Department of Oncological Urology, Petrov N. N. Research Institute of Oncology, Saint-Petersburg, Russia. , Department of Oncological Urology, Petrov N. N. Research Institute of Oncology, Saint-Petersburg, Russia. , Department of Oncological Urology, Petrov N. N. Research Institute of Oncology, Saint-Petersburg, Russia. , Department of Oncological Urology, Petrov N. N. Research Institute of Oncology, Saint-Petersburg, Russia. , Department of Oncological Urology, Petrov N. N. Research Institute of Oncology, Saint-Petersburg, Russia. , Clinic for Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany. , Clinic for Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany. , Saint-Petersburg Oncological Center, Saint-Petersburg, Russia.

PubMed