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TREATMENT OUTCOMES OF METASTATIC CASTRATION-SENSITIVE PROSTATE CANCER WITH ANDROGEN DEPRIVATION THERAPY COMBINED WITH DOCETAXEL AT 108 MILITARY CENTRAL HOSPITAL
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Abstract
Objective: To evaluate the treatment outcomes of metastatic castration-sensitive prostate cancer (mCSPC) using androgen deprivation therapy (ADT) combined with docetaxel. Subjects and methods: A cross-sectional descriptive study was conducted on 60 patients with mCSPC treated with ADT (surgical or medical castration) combined with docetaxel at 108 Central Military Hospital from January 1, 2022 to January 1, 2025. Results: The mean age was 71.7 years (range: 52–88). Common symptoms included bone pain (43.3%), urinary hesitancy (80%), urinary retention (31.7%). 38.3% of patients experienced a diagnostic delay of more than 6 months. Initial t-PSA levels were >100 ng/mL in 60% of patients. ECOG performance status was predominantly 1 (58.3%). Gleason scores ≥8 were observed in 73.3% of cases. Bone metastases were present in 88.3%. High-volume disease was seen in 81.7% of patients, while 18.3% had low-volume metastases. Surgical castration was performed in 58.3% and medical castration in 41.7%. PSA response (defined as a ≥50% decline from baseline) was achieved in 100% of patients. The median PSA nadir was 0.70 ng/mL in the surgical group and 1.80 ng/mL in the medical group (p=0.579). A time to PSA nadir ≥6 months was observed in 31.7% of the surgical group and 30.0% of the medical group. Median time to PSA nadir was 6.0 months (surgical) and 9.0 months (medical). Patients with PSA nadir <0.2 ng/mL had a longer progression-free survival (PFS) of 13.0 months compared to 7.0 months in those with PSA nadir ≥0.2 ng/mL (p=0.013). PFS was also longer in patients with time to PSA nadir ≥6 months (12.0 months) compared to those with <6 months (7.5 months) (p=0.044). The most common adverse events were fatigue (30%) and anorexia (30%). Conclusion: Patients with PSA nadir<0.2 ng/mL and time to PSA nadir≥6 months had significantly longer PFS. The combination of androgen deprivation therapy and docetaxel was effective and well-tolerated in the treatment of metastatic castration-sensitive prostate cancer.
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Keywords
Prostate cancer, PSA nadir, orchiectomy, progression-free survival
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