Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world‿experience

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• 作者：Paolo Tralongo ; ^{tralongo@raosr.it" class="auth_mail" title="E-mail the corresponding author} ; Sebastiano Bordonaro ; Annamaria Di Mari ; Francesco Cappuccio ; Sebastiano Rametta Giuliano
• 关键词：Cancer ; Chemotherapy ; Elderly ; Frail ; Prostate
• 刊名：Prostate International
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：4
• 期：1
• 页码：15-19
• 全文大小：307 K

文摘

In elderly patients affected by metastatic castration-resistant prostate cancer (mCRPC) chemotherapic treatment may be the choice if one considers not only the chronological age, but also the clinical status, the functional reserve, and the vulnerability of patients. Several studies have confirmed the survival benefit of docetaxel and vinorelbine among every class of age. Most CRP elderly patients are defined as frail, maybe due to comorbidities: these patients, who are unable to be candidates for a standard treatment, should be candidates for a more tolerable treatment.

Methods

Twenty-six elderly, frail patients were evaluated. The patients were affected by mCRPC and were receiving chemotherapy with intravenous weekly docetaxel (12 patients) or oral metronomic vinorelbine (14 patients). Safety and efficacy were investigated evaluating clinical and objective response and tolerability. The level of patient satisfaction with treatment was assessed through a questionnaire.

Results

No significant difference was found between groups in terms of 6-month progression-free survival: 57.1% for patients treated with oral metronomic vinorelbine versus 58.3% for patients treated with docetaxel. Median progression free survival was 8.6 months (95% confidence interval: 7.1–9.4 months), and 8.2 months (95% confidence interval: 6.9–9.3 months) for patients treated with oral metronomic vinorelbine and socetaxel, respectively. Oral metronomic vinorelbine was associated with increased patient satisfaction with respect to docetaxel administration. The most frequent side effect associated with oral metronomic vinorelbine was anemia and vomiting, with similar frequency compared to patients treated with docetaxel.

Conclusion

Weekly docetaxel and oral metronomic vinorelbine are equally effective and well tolerated in elderly unfit and frail patients affected by mCRPC. Metronomic vinorelbine treatment is associated with higher patient compliance and satisfaction.