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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (4): 686-691. doi: 10.19723/j.issn.1671-167X.2021.04.011

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Clinical efficacy of docetaxel combined with carboplatin in patients with metastatic castration-resistant prostate cancer

BAI Gao-chen,SONG Yi(),JIN Jie(),YU Wei,HE Zhi-song   

  1. National Urological Cancer Center, Beijing 100034, China
  • Received:2021-03-03 Online:2021-08-18 Published:2021-08-25
  • Contact: Yi SONG,Jie JIN E-mail:ddsongyi@263.net;jinjie@vip.163.com

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Abstract:

Objective: To observe the early efficacy and toxicity of docetaxel combined with carboplatin in patients with metastatic castration-resistant prostate cancer (mCRPC). Methods: From May 2017 to July 2019, fifteen patients with mCRPC treated in Peking University First Hospital were collected. The median age was 70 years (43-77 years), and the pathological types were all adenocarcinoma, which was confirmed as distant metastasis by imaging examination. They were given the chemotherapy of docetaxel combined with carboplatin. The specific method was as follows: each cycle was 28 days. Androgen deprivation therapy was administered routinely throughout the treatment period. Blood routine, liver and kidney function, blood clotting function and prostate-specific antigen (PSA) tests were performed before each cycle. Docetaxel was administered intravenously on the first day of each cycle at a dose of 75 mg/m2, and carboplatin was administered intravenously on the second day at the dose calculated by Calvert formula. The main outcome measures including PSA decline range, pain remission rate and occurrence of adverse reactions were observed and analyzed. Results: Among the 15 patients, 12 had completed at least 4 cycles of chemotherapy and had short-term efficacy evaluation. PSA decline range>50% was observed in 8 patients (66.7%). Among the 9 patients with bone pain, remarkable pain relief was observed in 4 patients (44.4%). Among the 4 patients with measurable metastatic lesions, 2 achieved partial response, 1 was evaluated as stable disease, and 1 was evaluated as progressive disease. The main adverse reactions of chemotherapy included bone marrow suppression, gastrointestinal reactions, fatigue and neurological disorders, and most of them were within the tolerable range. Conclusion: This report is a case series study of docetaxel combined with carboplatin in the treatment of mCRPC reported in China and the conclusions are representative. The chemotherapy of docetaxel combined with carboplatin has positive short-term efficacy and high safety in patients with mCRPC, which is worthy of further promotion and exploration in clinical practice.

Key words: Docetaxel, Carboplatin, Prostate cancer

CLC Number: 

  • R697+.3

Table 1

Clinical characteristics of 15 patients with mCRPC"

Characteristics n
Age/years
≤70 8
>70 7
Primary tumor (T stage)
T1-T2 2
T3-T4 13
Regional lymph node (N stage)
N0 1
N1 14
Distant metastasis (M stage)
M0 0
M1a 1
M1b 13
M1c 1
Gleason score
≤8 7
>8 8
PSA level before treatment/(mg/L)
≤20 5
>20 10
NRS for bone pain/(point)
No pain (0) 3
Mild pain (1-3) 1
Moderate pain (4-6) 7
Severe pain (7-10) 4
Treatment phase for mCRPC
First-line 4
Second-line 7
Third-line 4
Fourth-line or more 0

Figure 1

PSA changes in 12 patients with mCRPC who completed at least 4 cycles of chemotherapy A, PSA changes from baseline after 4 cycles of chemotherapy in patients at different treatment phases; B, PSA changes from baseline after 4 cycles of chemotherapy in all patients. PSA, prostate-specific antigen; mCRPC, metastatic castration-resistant prostate cancer."

Table 2

Short-term outcomes in 12 patients with mCRPC who completed at least 4 cycles of chemotherapy"

Items n (%)
PSA decline in 12 evaluable patients
>50% 8(66.6)
0%-50% 1(8.3)
<0% 3(25.0)
Pain response in 9 patients with ostalgia
Decreased 4(44.4)
Stable 4(44.4)
Increased 1(11.1)
RECIST assessment in 4 patients with measurable metastatic lesions
Complete response 0(0)
Partial response 2(50.0)
Stable disease 1(25.0)
Progressive disease 1(25.0)

Table 3

Occurrence of treatment-related adverse reactions in 15 patients with mCRPC [n (%)]"

Adverse reactions Total Grade 1 Grade 2 Grade 3 Grade 4
Leukopenia 6(40.0) 4(26.7) 2(13.3) 0(0) 0(0)
Anemia 6(40.0) 2(13.3) 2(13.3) 2(13.3) 0(0)
Thrombocytopenia 1(6.7) 1(6.7) 0(0) 0(0) 0(0)
Liver function damage 1(6.7) 1(6.7) 0(0) 0(0) 0(0)
Gastrointestinal hemorrhage 1(6.7) 0(0) 1(6.7) 0(0) 0(0)
Nausea/vomiting 3(20.0) 2(13.3) 1(6.7) 0(0) 0(0)
Diarrhea 1(6.7) 1(6.7) 0(0) 0(0) 0(0)
Constipation 1(6.7) 1(6.7) 0(0) 0(0) 0(0)
Fatigue 2(13.3) 1(6.7) 1(6.7) 0(0) 0(0)
Neurological disorders 2(13.3) 2(13.3) 0(0) 0(0) 0(0)
Pigmentation 1(6.7) 1(6.7) 1(6.7) 0(0) 0(0)
Severe infections 1(6.7) 0(0) 0(0) 0(0) 1(6.7)
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