There have been very few studies on the patterns of care and outcome of elderly (over 75 years) survivors with androgen independent prostate cancer (AIPC) who have been treated with docetaxel (Taxotere).
The records of 175 French men with AIPC, over the age of 75 years, were retrospectively examined. All of the men were treated with docetaxel during the time period of 2000 to 2007.
Ninety-five patients (54%) received a standard 3-wk regimen (SR), and 80 patients (46%) received an adapted regimen (AR) delivered on a weekly schedule with various times for rest periods. Patients treated with an AR were older (>80 yr) and had poorer performance status (PS; >/=2) than patients treated with the SR.
The prostate-specific antigen (PSA) response rates were not significantly different between the standard and adapted treatment groups (71% vs 68%, p=0.79). The median progression-free survival (PFS) was 7.4 months. The median overall survival (OS) was 15 months.
Early discontinuation of treatment because of toxicity occurred more frequently in the AR group than in the SR group (30% vs 8.4%, p=0.0005).
Docetaxel is a viable, feasible and effective treatment modality in elderly survivors. However, the optimal treatment amounts and schedules for frail men still remains to be established. Age by itself should not be used as a criterion to deny survivors docetaxel as a treatment for prostate cancer. Do not allow your doctor to exclude the use of chemotherapy because of your age.
Eur Urol. 2008 Aug 8. Epub ahead of print.
Joel T Nowak MA, MSW