The role of additional chemotherapy in the treatment of high-risk prostate cancer (PCa) remains a controversy. This meta-analysis aimed to investigate the effect of additional chemotherapy on high-risk PCa.
Randomized controlled trials (RCTs) about additional chemotherapy for high-risk PCa were searched in PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. We extracted HRs of overall survival (OS) and progression-free survival (PFS) for each trial and performed the meta-analysis using Review Manager 5.3.
Eight RCTs involving 4,007 patients were included. Data from four trials, which could collect OS, showed that additional chemotherapy could not significantly improve the OS in patients with high-risk PCa (HR: 0.93; 95% CI: 0.79-1.09; P=0.37). However, the pooled analysis suggested significantly longer PFS in high-risk PCa patients treated with additional chemotherapy (HR: 0.81; 95% CI: 0.74-0.90; P<0.0001). The meta-analysis showed additional chemotherapy to androgen-deprivation therapy improved PFS (HR: 0.82; 95% CI: 0.74-0.91; P=0.0002). Greater improvement in PFS was found in high-risk PCa patients treated with additional docetaxel-based chemotherapy (HR: 0.73; 95% CI: 0.64-0.83; P<0.00001). No prolonged PFS was observed in high-risk PCa patients with non-docetaxel-based chemotherapy (HR: 0.97; 95% CI: 0.83-1.14; P=0.74).
Additional chemotherapy, especially docetaxel-based chemotherapy, could significantly improve the PFS in high-risk PCa patients. More evidence about the effect of additional chemotherapy on OS is needed. Further investigations in PCa should also focus on the suitable population for chemotherapy as well as optimal use of chemotherapy.
基金:
Natural Science
Foundation of China (NSFC 81402110 and 81672547),
Science and Technology Support Program of Sichuan Province (2015SZ0230-3) and 1.3.5 project for disciplines of
excellence, West China Hospital, Sichuan University
语种:
外文
PubmedID:
中科院(CAS)分区:
出版当年[2018]版:
大类|3 区医学
小类|3 区生物工程与应用微生物4 区肿瘤学
最新[2023]版:
大类|4 区医学
小类|3 区生物工程与应用微生物4 区肿瘤学
第一作者:
第一作者机构:[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
共同第一作者:
通讯作者:
通讯机构:[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China[*1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
推荐引用方式(GB/T 7714):
Chen Junru,Zhang Xingming,Sun Guangxi,et al.The effect of additional chemotherapy on high-risk prostate cancer: a systematic review and meta-analysis.[J].OncoTargets and therapy.2018,11:9061-9070.doi:10.2147/OTT.S187239.
APA:
Chen Junru,Zhang Xingming,Sun Guangxi,Zhao Jinge,Liu Jiandong...&Zeng Hao.(2018).The effect of additional chemotherapy on high-risk prostate cancer: a systematic review and meta-analysis..OncoTargets and therapy,11,
MLA:
Chen Junru,et al."The effect of additional chemotherapy on high-risk prostate cancer: a systematic review and meta-analysis.".OncoTargets and therapy 11.(2018):9061-9070