A Cochrane review [Abstract] 1 included 47 studies with a total of 6929 subjects with prostate cancer. Estramustine, 5-fluorouracil, cyclophosphamide, doxorubicin, mitoxantrone, and docetaxel were studied. Only studies using docetaxel reported a small but significant improvement (< 2.5 months) in overall survival compared to best standard of care. The mean percentage of patients achieving at least a 50% reduction in PSA compared to baseline was as follows: estramustine 48%; 5-fluorouracil 20%; doxorubicin 50% (one study only); mitoxantrone 33%; and docetaxel 52%. Pain relief was reported in 35% to 76% of patients receiving either single agents or combination regimens. A three weekly regime of docetaxel significantly improved pain relief compared to mitoxantrone plus prednisone. All drugs were associated with toxicity. Quality of life was significantly improved with docetaxel compared to mitoxantrone plus prednisone.
Comment: The quality of evidence is downgraded by limitations in study quality (inadequate follow up, poor reporting).
Primary/Secondary Keywords