Backgrounds: In recent years, chemotherapy combined with steroids was shown to be an effective modality in the treatment of hormone-refractory prostate cancer (HRPC).
Design and Subjects: A retrospective evaluation has been done to assess the efficacy and toxicity of the chemohormonal regimen consisting of epirubicin, etoposide, and dexamethasone (EED) in patients with HRPC. We treated a total of 22 men who had failed hormonal therapy and antiandrogen withdrawal.
Methods and Results: Chemotherapy was given every 2 weeks and consisted of epirubicin (30 mg/m2 intravenously day 1) and etoposide (50 mg/m2 orally day 1-7). Dexamethasone (1.5 mg orally every other day) was given continuously until disease progression. Pain response evaluation was based on the analgesic use. The palliative effect of treatment (pain response/performance status change) was also determined. Toxicity was graded according to the Common Toxicity Criteria, version 2.0. Prostate specific antigen (PSA) levels showed a decline of 50% or greater in 9 of 22 patients (41%, 95% confidence interval, 21-64%). Moreover, 8 of 22 patients (36%) had a 75% decrease in PSA. The median time to biochemical progression was 5 months (range, 4-9 months). Seven of 15 symptomatic patients (47%) had pain response. The palliative effect has been achieved in 9 of 15 patients (60%). The EED regimen was well tolerated, with only three patients having grade 3 neutropenia. The median overall survival for the whole group of patients was 14.5 months (range, 3-35 months).
Conclusions: Chemohormonal EED regimen proved to be active and well tolerated in patients with HRPC.