@article{Zielinski_Azad_Chi_Tyldesley_2014, title={Population-based impact on overall survival after the introduction of docetaxel as standard therapy for metastatic castration resistant prostate cancer}, volume={8}, url={https://cuaj.ca/index.php/journal/article/view/2076}, DOI={10.5489/cuaj.2076}, abstractNote={<p><strong>Introduction: </strong>Utilization of docetaxel in patients with metastatic castration resistant prostate cancer (mCRPC) remains low despite its demonstrated survival benefit. In a population-based cohort, we sought to determine whether the introduction of docetaxel has improved overall survival (OS).</p><p><strong>Methods:</strong> A retrospective review was conducted of mCRPC patients treated with palliative radiotherapy to bone in British Columbia, Canada. Patients in the pre-docetaxel era (pre-DOC, prior to general availability of docetaxel for CRPC) received radiotherapy to bone (RT-B) from 1998 to 2001 and those in the docetaxel era (DOC) received radiotherapy from 2006 to 2009. Time of first radiotherapy to bone was used to select patients at a similar point in their disease state (i.e., onset of bone pain). The primary objective was to determine median OS in the two eras.</p><p><strong>Results: </strong>Of the 919 patients in the pre-DOC era and the 957 in the DOC era, 7% and 37% received docetaxel, respectively. The median OS from time of first palliative RT was 7.5 months versus 10.3 months (hazard ratio [HR]: 0.79, 95% confidence interval [CI] 0.72–0.87; p < 0.0001) in the pre-DOC and DOC cohorts, respectively. On multivariable analyses, both eras treated (HR 0.84; p = 0.001) and the receipt of docetaxel (HR 0.78; p < 0.001) were significantly associated with OS.</p><p><strong>Conclusion:</strong> Although docetaxel penetrance was <50%, median OS was significantly improved in the DOC era compared to the pre-DOC era. This is the first study to demonstrate that docetaxel improves OS in mCRPC patients at a population level.</p>}, number={7-8}, journal={Canadian Urological Association Journal}, author={Zielinski, Robert R. and Azad, Arun A. and Chi, Kim N. and Tyldesley, Scott}, year={2014}, month={Aug.}, pages={e520–3} }