Abstract
Purpose
To assess the efficacy and toxicity of the addition of estramustine to docetaxel-based chemotherapy for the treatment of castration-resistant prostate cancer.
Methods
We systematically searched, without language restrictions, for randomized clinical trials that compared docetaxel-based chemotherapy with or without estramustine in patients with histologically proven prostate cancer. The primary end point was overall survival (OS). Secondary endpoints were prostate-specific antigen (PSA) response rate and grade 3 or 4 toxicity. Data was extracted from the studies by 2 independent reviewers. The meta-analysis was performed by Stata version 10.0 software (Stata Corporation, College Station, Texas, USA).
Results
Four randomized clinical trials (totally 400 patients) were eligible. Meta-analysis showed that there was significant improvement in PSA response rate in docetaxel-based therapy with estramustine group, compared with docetaxel-based therapy group (OR = 1.55, 95% CI = 1.10–2.18, P = 0.012). With regard to OS (HR = 0.873, 95% CI = 0.55–1.40, P = 0.572), grade3 or 4 neutropenia (OR = 1.27, 95% CI = 0.61–2.7), anemia (OR = 1.04, 95% CI = 0.07–16.3), thrombocytopenia (OR = 0.87, 95% CI = 0.13–5.7), diarrhea (OR = 2.3, 95% CI = 0.36–14.9), nausea (OR = 1.14, 95% CI = 0.16–8.35), mucositis (OR = 1.66, 95% CI = 0.50–5.52) , and vomiting (OR = 1.53, 95% CI = 0.23–10.3), and there were no significant differences between the two groups.
Conclusions
This was the first meta-analysis of docetaxel-based therapy with estramustine versus docetaxel-based chemotherapy in the treatment of castration-resistant prostate cancer. Our meta-analysis did not support the addition of estramustine to docetaxel-based chemotherapy for the treatment of castration- resistant prostate cancer, based on no gain in survival.
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Conflict if interest
We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled “Docetaxel-based Therapy with or without Estramustine as First-line Chemotherapy for Castration-resistant Prostate Cancer: A Meta-analysis of Four Randomized Controlled Trials”.
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Qi, WX., Shen, Z. & Yao, Y. Docetaxel-based therapy with or without estramustine as first-line chemotherapy for castration-resistant prostate cancer: a meta-analysis of four randomized controlled trials. J Cancer Res Clin Oncol 137, 1785–1790 (2011). https://doi.org/10.1007/s00432-011-1052-7
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DOI: https://doi.org/10.1007/s00432-011-1052-7