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Weekly chemotherapy in advanced prostatic cancer
G Francini1, R Petrioli, A Manganelli
1Institute of Medical Pathology, University of Siena, Italy.
British Journal of Cancer
|June 1, 1993
Summary
Weekly epirubicin chemotherapy offers palliative benefits for advanced prostate cancer patients resistant to hormonal therapy. This regimen showed comparable response rates to doxorubicin but with fewer cardiac side effects and improved survival.
Area of Science:
- Oncology
- Medical Research
- Chemotherapy
Background:
- Advanced prostate carcinoma (stage D2) often becomes refractory to hormonal therapy, necessitating alternative treatment strategies.
- Chemotherapy regimens are evaluated for their efficacy and safety in managing hormone-refractory advanced prostate cancer.
Purpose of the Study:
- To evaluate the effectiveness of a weekly epirubicin chemotherapy regimen compared to doxorubicin in patients with advanced prostate carcinoma refractory to hormonal therapy.
- To assess palliative effects, tumor marker response, histological changes in bone metastases, cardiac performance, and survival rates.
Main Methods:
- A randomized phase II study involving 72 patients with stage D2 prostate carcinoma.
- Patients were randomized 2:1 to receive either weekly epirubicin (30 mg/m²) or doxorubicin (25 mg/m²).
- Response rates, symptom intensity, tumor markers, histological bone metastasis analysis, cardiac function, and survival were assessed after 12 chemotherapy courses.
Main Results:
- Response rates were similar between epirubicin (37.7%) and doxorubicin (33.3%) arms (P = 0.51).
- Responders showed significant decreases in pain, bone and prostatic tumor markers, and improvements in physical and emotional well-being.
- Histological analysis revealed reduced neoplastic invasion and new bone formation in bone metastases of responders.
- Cardiac performance worsened significantly more in the doxorubicin arm (P = 0.014).
- Median survival was longer in the epirubicin arm (12.5 months) compared to the doxorubicin arm (8.0 months) (P = 0.042).
Conclusions:
- Weekly epirubicin provides rapid palliative results in advanced, hormone-refractory prostate carcinoma, comparable to doxorubicin.
- Epirubicin demonstrates a potentially better safety profile regarding cardiac side effects and a trend towards improved survival.
- This regimen represents a viable option for palliative care in advanced prostate cancer patients who have failed hormonal therapy.