Feasibility of metronomic chemotherapy with tegafur-uracil, cisplatin, and dexamethasone for docetaxel-refractory prostate cancer

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  • Kubota Hiroki
    Department of Urology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health andWelfare Kainan Hospital, Aichi, Japan
  • Fukuta Katsuhiro
    Department of Urology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health andWelfare Kainan Hospital, Aichi, Japan
  • Yamada Kenji
    Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Hirose Masahito
    Department of Urology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health andWelfare Kainan Hospital, Aichi, Japan
  • Naruyama Hiromichi
    Department of Urology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health andWelfare Kainan Hospital, Aichi, Japan
  • Yanai Yoshimasa
    Department of Urology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health andWelfare Kainan Hospital, Aichi, Japan
  • Yamada Yasuyuki
    Department of Urology, The Aichi Prefectural Federation of Agricultural Cooperatives for Health andWelfare Kainan Hospital, Aichi, Japan
  • Watase Hideki
    Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Kawai Noriyasu
    Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Tozawa Keiichi
    Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Yasui Takahiro
    Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

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Abstract

<p>Objectives: To evaluate the efficacy of tegafur–uracil (UFT), a prodrug of 5-fluorouracil, plus cisplatin and dexamethasone in patients with docetaxel-refractory prostate cancers.</p><p>Methods: Twenty-five patients with docetaxel-refractory prostate cancer were administered oral UFT plus intravenous cisplatin (UFT-P therapy) and dexamethasone. Treatment responses were assessed monthly via prostate-specific antigen (PSA) level measurements. Treatment-related adverse events and overall survival were also assessed.</p><p>Results: UFT-P therapy resulted in decreased PSA levels in 14 (56%) patients and increased PSA levels in 11 (44%). In patients with increased PSA levels, 7 (64%) of the 11 patients displayed decreased PSA doubling times. The UFT-P therapy response rate was 84% (21/25 patients). Imaging studies revealed that tumor shrinkage during UFT-P therapy occurred in 1 patient in whom bilateral hydronephrosis caused by lymph node metastasis improved. The median survival time from docetaxel initiation was 36 months. In UFT-P-treated patients, the median PSA progression and overall survival times were 6 and 14 months, respectively. UFT-P treatment-related adverse events were mild diarrhea, general fatigue, and anorexia. Treatment was not discontinued for any of the patients. UFT-P therapy did not cause serious hepatic or renal dysfunction or pancytopenia.</p><p>Conclusions: UFT-P therapy is a safe and effective treatment for patients with docetaxel-refractory prostate cancer, although large-scale, multicenter, prospective studies are needed to validate these findings.</p>

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