[Low-dose docetaxel in combination with dexamethasone for hormone-refractory prostate cancer].

PURPOSE: Efficacy and tolerability of docetaxel-based chemotherapy against hormone-refractory prostate cancer (HRPC) has been shown lately. The objective of this study was to evaluate retrospectively the efficacy and toxicity of low-dose docetaxel in combination with dexamethasone. PATIENTS AND METHODS: Sixteen patients, with a median age of 69.5 years (range 54-85 years), diagnosed with HRPC were administered a treatment regimen consisting of docetaxel (60-80 mg/body or 50 mg/m2) once every 3 or 4 weeks and dexamethasone 1 mg daily at our institution between November, 2004 and March, 2010. RESULTS: The patients received a median of 11.5 cycles of treatment (range, 2-35 cycles). Eleven of 16 patients (68.8%) had a > or = 50% decrease in serum prostate-specific antigen. The median progression-free survival and overall survival times were 7.1 and 20.3 months, respectively. Grade 3 neutropenia occurred only in 2 patients. Infective endocarditis, gastrointestinal or cerebral hemorrhage, and compressive fracture were occurred in each patient. CONCLUSIONS: The combination of low-dose docetaxel every 3-4 weeks and dexamethasone daily was effective and well tolerated in patients with HRPC. However, it is necessary to pay continuous attention to side effects due to the frequent presence of comorbid diseases particularly in the elderly.

Combined chemotherapy with gemcitabine and cisplatin for metastatic urothelial carcinomas in patients 80 years of age and over.

BACKGROUND: This retrospective study aimed to determine the efficacy and toxicity of a combined chemotherapeutic regimen of gemcitabine and cisplatin (GC) for the treatment of metastatic urothelial carcinomas (UCs) in patients 80 years of age and over. PATIENTS AND METHODS: Twelve patients who were at least 80 years old and had been diagnosed with metastatic UC were treated with GC. The patient cohort consisted of 9 men and 3 women, with a median age of 83 (range 80-84) years. The median follow-up was 54 (range 14-80) months. RESULTS: Five out of the 12 patients (42%) showed an objective response, with two achieving a clinically complete response and three a partial response with GC. The median time to progression was 6 months, and the median overall survival was 14 months. The grade 3 and 4 toxicities of the regimen were primarily hematological, including anemia (33%), neutropenia (58%), and thrombocytopenia (50%). No grade 3 or 4 non-hematological toxicities were found. CONCLUSION: GC appears to be an effective and well-tolerated regimen for the treatment of metastatic UCs in very old patients.

Long-term results of combined chemotherapy with gemcitabine and cisplatin for metastatic urothelial carcinomas.

BACKGROUND: This retrospective study aimed to determine the long-term effects and toxicity of a combined chemotherapeutic regimen of gemcitabine and cisplatin (GC) in the treatment of metastatic urothelial carcinomas (UCs). METHODS: Seventy-one patients with metastatic UC were treated with GC (gemcitabine 1000 mg/m(2) on days 1, 8, and 15 and cisplatin 70 mg/m(2) on day 2 every 28 days). The patients were divided into 3 groups: patients who had not undergone prior chemotherapy (group 1), patients who relapsed more than 6 months after being treated with the prior cisplatin-based regimen (group 2), and patients in whom the prior cisplatin-based regimen demonstrated no effect (group 3). The median follow-up was 42 months. RESULTS: In group 1, 20 of the 32 patients (63%) showed an objective response, with 6 achieving a clinically complete response (CR) and 14 a partial response (PR) with GC. Ten of 32 patients (31%) and 1 of 7 patients (14%) showed objective responses in groups 2 and 3, respectively. Patients in group 2 who had previously been treated with regimens other than GC showed a better objective response (58%) than those with GC (15%). The median time to progression in group 1 was 6 months, and the median overall survival was 14 months. In all, the nonhematological toxicities associated with GC were quite mild. Grade 3-4 toxicity was primarily hematological, including anemia (19%), neutropenia (36%), and thrombocytopenia (42%). CONCLUSIONS: GC is therefore considered to be a highly effective and well-tolerated regimen with moderate toxicity for the treatment of metastatic UCs.

Inter/intra investigator variation in orchidometric measurements of testicular volume by ten investigators from five institutions.

AIM: To perform quality control studies on testicular volume measurements for a multi-center epidemiological study of male reproductive function. METHODS: We constructed a data matrix with a balanced assignment for 2 consecutive days by ten investigators (andrological career: 4-21 years) from five institutions and 12 male volunteers aged 20-26 years. Testicular volume was measured by Prader's orchidometer. A skilled technician also performed an ultrasound estimate of testicular volume. RESULTS: A statistically significant inter-investigator variation was found for both testes (P < 0.05). In addition, there was a statistically significant investigator-by-volunteer interaction in testicular volume measurement (P < 0.01). However, there was no statistically significant difference in the two measurements performed on consecutive days for either testis. The testicular volumes for both the right and left testes as estimated by ultrasonography were smaller than results using the orchidometer. However, there was no statistical significance (P > 0.05). The difference in experiences of the investigators did not significantly correlate with accuracy of measurements in either testis. CONCLUSION: The present study revealed significant differences in the results of estimation of testicular volume among the ten investigators, but intra-investigator variation was not considerable. Improved training and proper standardization of the measurement will be necessary before starting a multi-center study based on an andrological examination.

Relationships between erectile dysfunction, depression, and anxiety in Japanese subjects.

AIMS: This study aimed to elucidate the relationships between erectile dysfunction (ED) and depression or anxiety. METHODS: Subjects were 1,419 Japanese men aged 40-64 years. ED was assessed by the International Index of Erectile Function 5 (IIEF-5) score (Japanese version), and depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS). In this study ED cases were defined as those whose IIEF-5 value was less than 12, and a score of 8 or higher was used to classify a subject as suffering from depression or anxiety, respectively. The prevalence odds ratio (OR) of ED was calculated with confidence interval (CI) estimated by the Woolf's method by five age groups (40-44, 45-49, 50-54, 55-59, 60-64 years). To control for age, body mass index, smoking, and alcohol drinking factors, we conducted the multivariate logistic regression analysis for calculating adjusted ORs and 99% CIs. RESULTS: ED was significantly associated with depression in age groups 45-49 (OR 3.42, 99% CI 1.51-7.76) and 50-54 years (OR 2.43, 99% CI 1.11-5.35). After using multivariate analysis, adjusted OR also showed statistical significance. (OR 2.02, 99% CI 1.32-3.08). ED was significantly associated with anxiety in the 50-55-year-old age group (OR 2.48, 99% CI 1.12-5.47). After using multivariate analysis, adjusted OR also showed statistical significance (OR 1.77, 99% CI 1.15-2.72). The concomitant depression and anxiety group (A+D+) had significantly higher prevalence of ED than the control group (A-D-) in both the 45-49 and 50-54 age groups. (P < 0.01) CONCLUSION: ED associated significantly with depression and anxiety status only in late 40s to early 50s (45-55 years) in male Japanese. Furthermore, comorbidities of depression and anxiety strengthen this association. Our results might be useful in furthering understanding of ED etiology and determining a target population for prevention in ED subjects.