Docetaxel chemo + ADT with initial radiation is feasible

[JimmyToowong]

Concurrent and adjuvant docetaxel with three-dimensional conformal radiation therapy plus androgen deprivation for high-risk prostate cancer: Preliminary results of a multicentre phase II trial

Department of Oncology-Radiotherapy, Centre Hospitalier Universitaire, Grenoble, France.

We evaluate the feasibility of concomitant and adjuvant docetaxel combined with three-dimensional conformal radiotherapy (3D-CRT) and androgen deprivation in high-risk prostate carcinomas.

Fifty men with high-risk localized prostate cancer (16), locally advanced (28) or very high-risk prostate cancer (6) were included. Seventy Gy were delivered on prostate and seminal vesicles in 35 fractions, concurrently with weekly docetaxel (20mg/m2). Three weeks after the completion of 3D-CRT, docetaxel was given for 3 cycles (60mg/m(2)), every 3weeks. Patients had to receive LHRH agonist during 3years.

The intent to treat analysis shows that four patients out of 15 stopped prematurely the chemotherapy due to grade 3-4 acute toxicity. In the per protocol analysis, 46 patients completed a full-dose chemoradiation regimen representing 413 cycles: five patients experienced a grade 3 toxicity, and 15 patients experienced a grade 2 toxicity. With a median follow-up of 54months, the 5-year clinical disease-free survival was 66.72% and the 5-year survival was 92.15%.

3D-CRT with androgen deprivation and concurrent weekly docetaxel, followed by three cycles of adjuvant docetaxel may be considered as feasible in high-risk prostate cancer and deserved to be evaluated in a phase III randomized trial.

Written by:

Bolla M, Hannoun-Levi JM, Ferrero JM, Maingon P, Buffet-Miny J, Bougnoux A, Bauer J, Descotes JL, Fourneret P, Jover F, Colonna M. [1]

Reference: Radiother Oncol. 2010 Sep 14. Epub ahead of print.

doi: 10.1016/j.radonc.2010.08.012

PMID: 20846737 Forum: Primary hormone therapy Title: Docetaxel chemo + ADT with initial radiation is feasible

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