The efficacy and safety of docetaxel chemotherapy in the treatment of localised high-risk prostate cancer: a Meta-analysis

Q4 Medicine 中华泌尿外科杂志 Pub Date : 2019-11-15 DOI:10.3760/CMA.J.ISSN.1000-6702.2019.11.012

Qing-Feng Qin, Na Li, Shengzi Wang, Xue Zhao, Zhaohui S. Qin, Yuanhu Yao

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Abstract

Objective The role of additional docetaxel chemotherapy in the treatment of localised high-risk prostate cancer (PCa) remains a controversy. This meta-analysis aimed to investigate the effect of additional docetaxel chemotherapy on localised high-risk PCa. Methods A computerized search was performed in Pubmed, Embase, Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang Data to collect clinical controlled trails on localised high-risk PCa treated with docetaxel chemotherapy from the inception to April 2019. The Review Manager 5.3 software was used to perform meta-analysis of survival data and adverse events. Results Six literatures were enrolled, including 3 187 patients. Compared with the standard treatment (local treatment combined with endocrine therapy) group, the progression-free survival (PFS) was prolonged in the standard treatment plus docetaxel group, and the difference was statistically significant. [hazard ratio(HR)=0.75, 95%CI 0.65-0.86, P<0.01]. Patients in the standard treatment plus docetaxel group had longer overall survival (OS) and biochemical recurrence-free survival (BRFS) in comparison with standard treatment group, but the difference was not statistically significant (HR=0.843, 95%CI 0.68-1.01, P=0.06; HR=0.86, 95%CI 0.69-1.07, P=0.17). In terms of safety, the incidence of adverse reactions was increased in the standard treatment plus docetaxel group, including the incidence of grade ≥3 neutropenia (RR=44.14, 95%CI 19.15-101.71, P<0.01), the incidence of grade ≥3 febrile neutropenia (RR=13.4, 95%CI 7.93-22.65, P<0.01) and the incidence of grade ≥3 diarrhea (RR=13.43, 95%CI 3.21-56.16, P<0.01). Conclusions Additional docetaxel chemotherapy could significantly improve the PFS in localised high-risk PCa patients. OS and BRFS were prolonged, but the difference was not statistically significant. Key words: Prostatic neoplasms; High-risk; Docetaxel; Prognosis; Meta-analysis

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多西他赛化疗治疗局部高危前列腺癌的疗效和安全性:一项荟萃分析

目的多西他赛联合化疗在局部高危前列腺癌(PCa)治疗中的作用仍存在争议。本荟萃分析旨在探讨额外的多西他赛化疗对局部高危PCa的影响。方法计算机检索Pubmed、Embase、Cochrane Library、Web of Science、CBM、CNKI、VIP、万方数据等数据库，收集自成立以来至2019年4月多西他赛化疗治疗局部高危PCa的临床对照试验。使用Review Manager 5.3软件对生存数据和不良事件进行荟萃分析。结果纳入6篇文献，包括3 187例患者。与标准治疗(局部治疗联合内分泌治疗)组相比，标准治疗加多西他赛组无进展生存期(PFS)延长，差异有统计学意义。(风险比(人力资源)= 0.75,95% ci 0.65 - -0.86, P < 0.01)。标准治疗加多西他赛组患者的总生存期(OS)和生化无复发生存期(BRFS)较标准治疗组更长，但差异无统计学意义(HR=0.843, 95%CI 0.68-1.01, P=0.06;Hr =0.86, 95%ci 0.69-1.07, p =0.17)。在安全性方面，标准治疗加多西他赛组不良反应发生率升高，包括≥3级中性粒细胞减少发生率(RR=44.14, 95%CI 19.15 ~ 101.71, P<0.01)、≥3级发热性中性粒细胞减少发生率(RR=13.4, 95%CI 7.93 ~ 22.65, P<0.01)和≥3级腹泻发生率(RR=13.43, 95%CI 3.21 ~ 56.16, P<0.01)。结论多西他赛化疗可显著改善局部高危PCa患者的PFS。OS和BRFS均有延长，但差异无统计学意义。关键词:前列腺肿瘤;高风险;多西他赛;预后;荟萃分析

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来源期刊

中华泌尿外科杂志 Medicine-Nephrology

CiteScore

0.10

自引率

0.00%

发文量

14180

期刊介绍： Chinese Journal of Urology (monthly) was founded in 1980. It is a publicly issued academic journal supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. This journal mainly reports on the latest scientific research results and clinical diagnosis and treatment experience in the professional field of urology at home and abroad, as well as basic theoretical research results closely related to clinical practice. The journal has columns such as treatises, abstracts of treatises, experimental studies, case reports, experience exchanges, reviews, reviews, lectures, etc. Chinese Journal of Urology has been included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Chinese Science Citation Database Source Journal (including extended version), and also included in American Chemical Abstracts (CA). The journal has been rated as a quality journal by the Association for Science and Technology and as an excellent journal by the Chinese Medical Association.