Docetaxol in metastatic prostate cancer

Sritharan, K.

Docetaxol in metastatic prostate cancer - 2017

NMUH Staff Publications EMBASE 29

<span style="font-size: 10pt;">Background to the audit: Docetaxol is used in the management of metastatic prostate cancer. Six cycles are given upfront in hormone sensitive prostate cancer and ten cycles are recommended in castrate resistant disease. ASCO recommends using colony stimulating factors prophylactically when the febrile neutropenia risk is greater than 20%. The dose is 75 mg/m[2] given every three weeks. Many older men at NMUH were given a dose of 65 mg/ m[2] to ensure tolerability. Standard: As per the TAX 327 trial[2], rates of febrile neutropenia rates were 3% and in Stampede[3], the rates were 12%. Indicator: 1. Primary aim of audit is to establish rates of febrile neutropenia and neutropenia in patients receiving Docetaxol. 2. We also explored the rates of response and toxicities between men receiving 65mg/m[2] versus 75mg/m[2] of Docetaxol. Target: Less than 12% of patients receiving Docetaxol develop febrile neutropenia. Methodology: Audit was performed retrospectively. Patients with metastatic prostate cancer who were prescribed Docetaxol between January 2014 and 2016 were identified using the chemotherapy prescribing system, Chemocare. Further information about admissions was obtained from the hospital computer database and notes. Results of first audit round: - 21 patients identified, aged between 54 and 86 years old. - 8 patients received a dose of 60mg/m2 and 13 received a dose of 75mg/m[2]. - 15 patients had castrate resistant disease and six patients had hormone sensitive disease. - Rate of neutropenia sepsis was 25% and rate of grade 3-4 neutropeniawas 15%. Rate of febrile neutropeniawas higher than expected and rate of grade 3-4 neutropenia was in keeping with the trials. - Rates of response were similar in the 60mg/m[2] and the 75mg/m[2] group. The toxicities seemed largely similar in both groups, and the number of hospital admissions was overall less in the 60mg/m[2] group. First action plan: 1. Add in a five-day course of prophylactic granulocyte-colony stimulating factor (G-CSF) for patients receiving Docetaxol chemotherapy in metastatic prostate cancer as per ASCO guidelines. 2. The number of patients included in the 2nd part of the audit is small therefore further data is required.&nbsp;[Conference abstract]</span>
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