Has anyone tried Fractionated Chemo or have experience with Dr Chin in Seattle.

[CarlinPhoenix]

I'm looking for feedback regarding treatment with Fractionated Chemo. I'm sure there are many places to get this treatment but the place I know is Dr Chin in Seattle. I have a friend who is being successfully treated for her ovarian cancer by Dr Chin but I would like to know how it is working for Advanced Metastatic Prostrate Cancer patients. Thanks for any input you have. Carl

[Tall_Allen]

Do you mean weekly instead of every 3 weeks? When they did the trial for docetaxel, they found that " The median survival was 18.9 months in the group given docetaxel every 3 weeks, and 17.4 months in the group given weekly docetaxel" They also found no difference in quality of life.

nejm.org/doi/full/10.1056/N...

[AlanMeyer in reply to Tall_Allen]

I'm not certain of every case, but I'm pretty sure that some of the men I read about who had weekly instead of three week docetaxel cycles were given the weekly cycle because they had very bad reactions to the higher dose. They reported that they were considering quiting treatment but found that they could continue much more comfortably at the weekly dose.

I only skimmed the whole article but I did look more at the tables. Table 4 showed that 32% of the three weekly group but only 2% of the weekly group suffered grade 3 or 4 neutropenia. Looking at the rest of that table I wonder about the quality of life conclusion - though it may be that going through a nasty treatment once every three weeks, even if it's nastier than the once a week treatment, produces a subjectively better quality of life, at least for the patients that didn't suffer neutropenia.

I'm thinking that the authors of the study did the right thing in limiting their main conclusions to stating that docetaxel produced superior results as compared to mitoxantrone.

[Tall_Allen in reply to AlanMeyer]

QOL is shown in Figure 2 - it was based on the FACT-P questionnaire: "The percentage of patients who had an improvement in the quality of life was similar in the two docetaxel groups (22 percent in the group given docetaxel every three weeks and 23 percent in the group given weekly docetaxel) " You are right that neutropenia was much higher, but it all seemed to even out in the end- ">1 serious adverse event was 26% for every 3 weeks and 29% for weekly" It makes sense to offer it to anyone who does poorly on the every 3 week regime.

[CarlinPhoenix in reply to Tall_Allen]

Thank you Allen. Good information. Dr Chin in Portland offers reduced dosage on a more frequent basis along with other medication protocols. I'm pretty sure his approach is not a standard of care therapy.

[cesanon in reply to Tall_Allen]

Hmmm very counterintuitive.

There must be some rational supporting fractionated. Do you know what it is?

[cesanon in reply to cesanon]

Oh, is it less neutropenia?

[BigM62 in reply to cesanon]

It’s to help combat severe nuetropenia. My doc suggested this at one point when I was needing 3+ neurogeni shots for each round to recover my blood counts.