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Journal of Neuro-Oncology

, Volume 107, Issue 1, pp 191–196 | Cite as

Central nervous system metastases from castration-resistant prostate cancer in the docetaxel era

  • Orazio CaffoEmail author
  • Angela Gernone
  • Cinzia Ortega
  • Teodoro Sava
  • Giacomo Cartenì
  • Gaetano Facchini
  • Giovanni Lo Re
  • Placido Amadio
  • Roberto Bortolus
  • Vincenzo Pagliarulo
  • Veronica Prati
  • Antonello Veccia
  • Enzo Galligioni
Clinical Study – Patient Study

Abstract

Central nervous system (brain or leptomeningeal) metastases (BLm) are considered rare in castration-resistant prostate cancer (CRPC) patients. Now that docetaxel has become the reference drug for first-line treatment of CRPC, patients whose disease is not controlled by hormonal manipulations may live much longer than before and have higher risk of developing BLm. We retrospectively reviewed the records of all patients with CRPC attending our centres from 2002 to 2010, and identified all of those who were diagnosed as having BLm and received (or were considered to have been eligible to receive) docetaxel-based treatment. We identified 31 cases of BLm (22 brain metastases and 9 leptomeningeal metastases) with an incidence of 3.3%. BLm-free survival was 43.5 months, and survival after BLm discovery was 4 months. With six patients surviving for more than 1 year after developing BLm, the projected 1-year BL-S rate was 25.8%. The findings of our study may be relevant in clinical practice as they indicate that incidence of BLm in CRPC patients in the docetaxel era seems to be higher than in historical reports, meaning that special attention should be paid to the appearance of neurological symptoms in long-term CRPC survivors because they may be related to BLm.

Keywords

Castration-resistant prostate cancer Brain metastases Leptomeningeal metastases Docetaxel Chemotherapy 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Orazio Caffo
    • 1
    Email author
  • Angela Gernone
    • 2
  • Cinzia Ortega
    • 3
  • Teodoro Sava
    • 4
  • Giacomo Cartenì
    • 5
  • Gaetano Facchini
    • 6
  • Giovanni Lo Re
    • 7
  • Placido Amadio
    • 8
  • Roberto Bortolus
    • 9
  • Vincenzo Pagliarulo
    • 10
  • Veronica Prati
    • 11
  • Antonello Veccia
    • 1
  • Enzo Galligioni
    • 1
  1. 1.Department of Medical OncologySanta Chiara HospitalTrentoItaly
  2. 2.Department of Medical OncologyCivil HospitalBariItaly
  3. 3.Department of Medical OncologyInstitute for Cancer Research and TreatmentCandioloItaly
  4. 4.Department of Medical Oncology dOMaggiore HospitalVeronaItaly
  5. 5.Department of Medical OncologyCardarelli HospitalNaplesItaly
  6. 6.Medical Oncology Division – Uro-Gynaecological DepartmentNational Cancer Institute of NapoliNaplesItaly
  7. 7.Department of Medical OncologySanta Maria degli Angeli HospitalPordenoneItaly
  8. 8.Department of Medical OncologyGaribaldi HospitalCataniaItaly
  9. 9.Department of Radiotherapy OncologyNational Cancer InstituteAvianoItaly
  10. 10.Department of UrologyUniversity of BariBariItaly
  11. 11.Department of Medical OncologyInstitute for Cancer Research and TreatmentCandioloItaly

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