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Adjuvant chemotherapy + ADT in high-risk patients after surgery

Posted Dec 19 2009 12:00am

A number of trials are currently evaluating the potential value of adjuvant chemotherapy after first-line treatment in men with high-risk prostate cancer. The effects of this form of treatment on long-term outcomes still to be established, but …

A small, randomized, European, Phase II study by Ploussard et al. has demonstrated that the addition of 8 weeks of paclitaxel to androgen deprivation therapy (ADT) as adjuvant therapy for men with high-risk disease post-prostatectomy appears to be feasible and to have minimal impact on the patients’ quality of life.

This was a prospective, randomized trial in which, after radical prostatectomy, 47 patients received either ADT alone or ADT + paclitaxel once weekly for 8 weeks, with 23 of the patients beling treated in the paclitxel arm of the study.

The results of this trial showed that:

  • 23/23 patients (100 percent) completed eight cycles of paclitaxel.
  • Toxicity in the paclitaxel patients was predominantly of grade 1-2 severity.
  • There were no differences in the quality of life (EORTC QLQ-C30) scores between the two groups of patients at baseline
  • There were also no differences in the quality of life scores between the two groups of patients at their last assessment (24 months after surgery).
  • Urinary continence was complete at 1 year after surgery for all patients and no significant differences were noted at each assessment between the two groups.

It will be a significant period of time before we have clear evidence of the effectiveness of taxane-based chemotherapy as adjuvant treatment for high-risk patients in association with first-line therapy. However, this Phase II trial does add to the confidence that this type of adjuvant treatment can be offered to patients without severe adverse effects and with curative intent.

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