Central nervous system metastases from castration-resistant prostate cancer in the docetaxel era

Central nervous system (brain or leptomeningeal) metastases (BLm) are considered rare in castration-resistant prostate cancer (CRPC) patients. Now that docetaxel has become the reference drug for first-line treatment of CRPC, patients whose disease is not controlled by hormonal manipulations may liv...

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Bibliographic Details
Published in:Journal of neuro-oncology 2012-03, Vol.107 (1), p.191-196
Main Authors: Caffo, Orazio, Gernone, Angela, Ortega, Cinzia, Sava, Teodoro, Cartenì, Giacomo, Facchini, Gaetano, Re, Giovanni Lo, Amadio, Placido, Bortolus, Roberto, Pagliarulo, Vincenzo, Prati, Veronica, Veccia, Antonello, Galligioni, Enzo
Format: Article
Language:English
Subjects:
Adenocarcinoma - drug therapy
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Aged
Antineoplastic Agents - adverse effects
Brain
Brain Neoplasms - chemically induced
Brain Neoplasms - mortality
Brain Neoplasms - secondary
Central nervous system
Clinical Study – Patient Study
Follow-Up Studies
Humans
Male
Medicine
Medicine & Public Health
Meningeal Neoplasms - chemically induced
Meningeal Neoplasms - mortality
Meningeal Neoplasms - secondary
Meninges
Metastases
Middle Aged
Neoplasms, Hormone-Dependent - drug therapy
Neoplasms, Hormone-Dependent - mortality
Neoplasms, Hormone-Dependent - pathology
Neurology
Oncology
Orchiectomy
Prostate cancer
Prostatic Neoplasms - drug therapy
Prostatic Neoplasms - mortality
Prostatic Neoplasms - pathology
Retrospective Studies
Risk factors
Survival
Survival Rate
Taxoids - adverse effects
Treatment Outcome
Citations: Items that this one cites
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Summary:Central nervous system (brain or leptomeningeal) metastases (BLm) are considered rare in castration-resistant prostate cancer (CRPC) patients. Now that docetaxel has become the reference drug for first-line treatment of CRPC, patients whose disease is not controlled by hormonal manipulations may live much longer than before and have higher risk of developing BLm. We retrospectively reviewed the records of all patients with CRPC attending our centres from 2002 to 2010, and identified all of those who were diagnosed as having BLm and received (or were considered to have been eligible to receive) docetaxel-based treatment. We identified 31 cases of BLm (22 brain metastases and 9 leptomeningeal metastases) with an incidence of 3.3%. BLm-free survival was 43.5 months, and survival after BLm discovery was 4 months. With six patients surviving for more than 1 year after developing BLm, the projected 1-year BL-S rate was 25.8%. The findings of our study may be relevant in clinical practice as they indicate that incidence of BLm in CRPC patients in the docetaxel era seems to be higher than in historical reports, meaning that special attention should be paid to the appearance of neurological symptoms in long-term CRPC survivors because they may be related to BLm.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-011-0734-y