Vol. 65 No. 5 (2019), ORIGINAL ARTICLES. A. PROTOCOLS OF CLINICAL RESEARCH

Vol. 65 No. 5 (2019)

NEOADJUVANT FOR PATIENTS WITH HIGH AND VERY HIGH RISK PROSTATE CANCER

ORIGINAL ARTICLES. A. PROTOCOLS OF CLINICAL RESEARCH

https://doi.org/10.37469/0507-3758-2019-65-5-726-735

Published 01.05.2019

A. Nosov⁺⁻
Sergey Reva⁺⁻
M. Berkut⁺⁻
Svetlana Protsenko⁺⁻
A. Arnautov⁺⁻
Ilya Zyatchin⁺⁻
Sergey Petrov⁺⁻

A. Nosov

N.N. Petrov NMRC of oncology» of the Ministry of Healthcare of the Russian Federation

Sergey Reva

N.N. Petrov NMRC of oncology» of the Ministry of Healthcare of the Russian Federation, Pavlov First Saint Petersburg State Medical University

M. Berkut

N.N. Petrov NMRC of oncology» of the Ministry of Healthcare of the Russian Federation

Svetlana Protsenko

N.N. Petrov NMRC of oncology» of the Ministry of Healthcare of the Russian Federation

A. Arnautov

Pavlov First Saint Petersburg State Medical University

Ilya Zyatchin

Pavlov First Saint Petersburg State Medical University

Sergey Petrov

N.N. Petrov NMRC of oncology» of the Ministry of Healthcare of the Russian Federation, Pavlov First Saint Petersburg State Medical University

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Keywords

PROSTATE CANCER
RADICAL PROSTATECTOMY
NEOADJUVANT THERAPY
CHEMOTHERAPY
HORMONAL THERAPY
DOCETAXEL
DEGARELIX
ADVERSE EVENTS

How to Cite

Nosov, A., Reva, S., Berkut, M., Protsenko, S., Arnautov, A., Zyatchin, I., & Petrov, S. (2019). NEOADJUVANT FOR PATIENTS WITH HIGH AND VERY HIGH RISK PROSTATE CANCER. Voprosy Onkologii, 65(5), 726–735. https://doi.org/10.37469/0507-3758-2019-65-5-726-735

Abstract

Objective: to assess safety, pathological response rate, and long-term oncologic outcomes of radical prostatectomy (RP) after neoadjuvant chemotherapy using docetaxel in prostate cancer (PCa) patients of high and very high risk groups.

Materials and methods: 86 patients with high and very high risk PCa (PSA>20 ng/ml, Gleason score 8 and more, or clinical stage cT2c and more) were included, among them 46 received neoadjuvant (NCGT/RP group) treatment followed by RP and 40 patients received RP only. with a median follow-up of 11.4 years after RP. Neoadjuvant treatment included 3-weekly docetaxel (75 mg/m2 for up to 6 cycles) with concomitant degarelix (6 monthly injections). Results: NCGT cycle was started in 39 patients and completed in full dose and planned regimen in 34 (87.2%) patients. Toxicities were moderate. A statistically significant reduction of PSA>50% post-chemohormonal therapy was observed in all 39 cases. Among patients with completed neoadjuvant treatment RP was performed in 33 (97.1%) patients. Lower postoperative stage was noticed in 38.5% in NCGT/RP group compared with 2.7% in RP group. Similarly, positive surgical margin rate was higher in group without neoadjuvant therapy - 43.2% and 25.6% (RP group). Adjuvant or deferred treatment received 25 (67.6%) and 13 (39.4%) in RP and NCGT/RP group, respectively.

Conclusion: The use of neoadjuvant chemohormonal therapy before the RP in selected regimen and dose represents a safe strategy resulting in benefit in early oncological results. Given the limitations of the study this concept should be evaluated in large prospective controlled studies.

https://doi.org/10.37469/0507-3758-2019-65-5-726-735

##article.numberofdownloads## 47

##article.numberofviews## 115

PDF (Русский)

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