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Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world” experience

BACKGROUND: In elderly patients affected by metastatic castration-resistant prostate cancer (mCRPC) chemotherapic treatment may be the choice if one considers not only the chronological age, but also the clinical status, the functional reserve, and the vulnerability of patients. Several studies have...

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Autores principales: Tralongo, Paolo, Bordonaro, Sebastiano, Di Mari, Annamaria, Cappuccio, Francesco, Rametta Giuliano, Sebastiano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asian Pacific Prostate Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789324/
https://www.ncbi.nlm.nih.gov/pubmed/27014659
http://dx.doi.org/10.1016/j.prnil.2015.12.003
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author Tralongo, Paolo
Bordonaro, Sebastiano
Di Mari, Annamaria
Cappuccio, Francesco
Rametta Giuliano, Sebastiano
author_facet Tralongo, Paolo
Bordonaro, Sebastiano
Di Mari, Annamaria
Cappuccio, Francesco
Rametta Giuliano, Sebastiano
author_sort Tralongo, Paolo
collection PubMed
description BACKGROUND: In elderly patients affected by metastatic castration-resistant prostate cancer (mCRPC) chemotherapic treatment may be the choice if one considers not only the chronological age, but also the clinical status, the functional reserve, and the vulnerability of patients. Several studies have confirmed the survival benefit of docetaxel and vinorelbine among every class of age. Most CRP elderly patients are defined as frail, maybe due to comorbidities: these patients, who are unable to be candidates for a standard treatment, should be candidates for a more tolerable treatment. METHODS: Twenty-six elderly, frail patients were evaluated. The patients were affected by mCRPC and were receiving chemotherapy with intravenous weekly docetaxel (12 patients) or oral metronomic vinorelbine (14 patients). Safety and efficacy were investigated evaluating clinical and objective response and tolerability. The level of patient satisfaction with treatment was assessed through a questionnaire. RESULTS: No significant difference was found between groups in terms of 6-month progression-free survival: 57.1% for patients treated with oral metronomic vinorelbine versus 58.3% for patients treated with docetaxel. Median progression free survival was 8.6 months (95% confidence interval: 7.1–9.4 months), and 8.2 months (95% confidence interval: 6.9–9.3 months) for patients treated with oral metronomic vinorelbine and socetaxel, respectively. Oral metronomic vinorelbine was associated with increased patient satisfaction with respect to docetaxel administration. The most frequent side effect associated with oral metronomic vinorelbine was anemia and vomiting, with similar frequency compared to patients treated with docetaxel. CONCLUSION: Weekly docetaxel and oral metronomic vinorelbine are equally effective and well tolerated in elderly unfit and frail patients affected by mCRPC. Metronomic vinorelbine treatment is associated with higher patient compliance and satisfaction.
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spelling pubmed-47893242016-03-24 Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world” experience Tralongo, Paolo Bordonaro, Sebastiano Di Mari, Annamaria Cappuccio, Francesco Rametta Giuliano, Sebastiano Prostate Int Original Article BACKGROUND: In elderly patients affected by metastatic castration-resistant prostate cancer (mCRPC) chemotherapic treatment may be the choice if one considers not only the chronological age, but also the clinical status, the functional reserve, and the vulnerability of patients. Several studies have confirmed the survival benefit of docetaxel and vinorelbine among every class of age. Most CRP elderly patients are defined as frail, maybe due to comorbidities: these patients, who are unable to be candidates for a standard treatment, should be candidates for a more tolerable treatment. METHODS: Twenty-six elderly, frail patients were evaluated. The patients were affected by mCRPC and were receiving chemotherapy with intravenous weekly docetaxel (12 patients) or oral metronomic vinorelbine (14 patients). Safety and efficacy were investigated evaluating clinical and objective response and tolerability. The level of patient satisfaction with treatment was assessed through a questionnaire. RESULTS: No significant difference was found between groups in terms of 6-month progression-free survival: 57.1% for patients treated with oral metronomic vinorelbine versus 58.3% for patients treated with docetaxel. Median progression free survival was 8.6 months (95% confidence interval: 7.1–9.4 months), and 8.2 months (95% confidence interval: 6.9–9.3 months) for patients treated with oral metronomic vinorelbine and socetaxel, respectively. Oral metronomic vinorelbine was associated with increased patient satisfaction with respect to docetaxel administration. The most frequent side effect associated with oral metronomic vinorelbine was anemia and vomiting, with similar frequency compared to patients treated with docetaxel. CONCLUSION: Weekly docetaxel and oral metronomic vinorelbine are equally effective and well tolerated in elderly unfit and frail patients affected by mCRPC. Metronomic vinorelbine treatment is associated with higher patient compliance and satisfaction. Asian Pacific Prostate Society 2016-03 2016-01-21 /pmc/articles/PMC4789324/ /pubmed/27014659 http://dx.doi.org/10.1016/j.prnil.2015.12.003 Text en Copyright © 2015 Asian Pacific Prostate Society, Published by Elsevier. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Tralongo, Paolo
Bordonaro, Sebastiano
Di Mari, Annamaria
Cappuccio, Francesco
Rametta Giuliano, Sebastiano
Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world” experience
title Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world” experience
title_full Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world” experience
title_fullStr Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world” experience
title_full_unstemmed Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world” experience
title_short Chemotherapy in frail elderly patients with hormone-refractory prostate cancer: A “real world” experience
title_sort chemotherapy in frail elderly patients with hormone-refractory prostate cancer: a “real world” experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789324/
https://www.ncbi.nlm.nih.gov/pubmed/27014659
http://dx.doi.org/10.1016/j.prnil.2015.12.003
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