The purpose of the study was to find optimal treatment for hormone-refractory prostate cancer. We compared efficacy and toxicity of 4 chemotherapy schedules: 1) mitoxantrone 12 mg/m2 intravenously once three-weekly; prednizolone 10 mg daily per os (MP); 2) mitoxantrone 12 mg/m2 intravenously once threeweekly; cisplatin 60 mg/m2 intravenously once three-weekly; prednizolone 10 mg daily per os (MCP); 3) docetaxel 75 mg/m2 intravenously once three-weekly; estramustine 300 mg/m2 daily per os; prednizolone 10 mg daily per os (DEP); 4) doxorubicin 20 mg/m2 intravenously, day 1, weeks 1, 3 and 5; ketoconazole 1200 mg/day per os, days 1 through 7, weeks 1, 3 and 5; docetaxel 20 mg/m2 intravenously day 1, weeks 2, 4 and 6; estramustine 420 mg/day per os, days 1 through 7, weeks 2, 4 and 6; prednizolone 10 mg/day per os (DEKAP). A total of 39 patients were enrolled. The MP combination was low effective (8.7%) in first-line chemotherapy for hormone-refractory prostate cancer, while taxane-based schedules used mainly in the second-line induced a rather high response: DEP 40% and DEKAP 30%. Maximal response in cases with hormone-refractory prostate cancer was achieved when docetaxel-containing regimens were used. They may be recommended as second-line chemotherapy after mitoxantrone-containing schedules.
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