Novel combination chemotherapy with radiotherapy for prostate squamous cell carcinoma

Abstract

Squamous cell carcinoma of the prostate is a rare tumor. It has been typically described as an aggressive cancer, with a median survival time of 14 months. We present a case of locally advanced squamous cell carcinoma of the prostate with a regional lymph node metastasis. The patient received a novel combination chemotherapy regimen, docetaxel, cisplatin, and 5-fluorouracil, with radiotherapy to the whole pelvis and prostate. He was subsequently treated with seven courses of docetaxel, cisplatin, and 5-fluorouracil chemotherapy without any severe adverse events. We identified a 60.1 % reduction in the prostatic tumor, and the lymph node metastasis was shrunk after chemotherapy. A needle biopsy of the prostate after chemotherapy revealed no malignancy. No recurrence has been observed for 24 months. A combination of docetaxel, cisplatin, and 5-fluorouracil chemotherapy and radiotherapy might be an effective therapy for squamous cell carcinoma of the prostate.

Primary prostatic squamous cell carcinoma

“…Squamous cell carcinoma of the prostate has a worse prognosis than adenocarcinoma, with an average survival of 14 months after diagnosis. 5 Treatment options are typically limited. Of note, long term survival has been reported with combined chemotherapy and low-dose radiation with cisplatin and 5-fluorouracil.…”

“…Of note, long term survival has been reported with combined chemotherapy and low-dose radiation with cisplatin and 5-fluorouracil. 5 The decision was made to pursue adjuvant docetaxel and carboplatin due to our patient's other medical comorbidities. Adjuvant radiation therapy was not pursued due to evidence of metastatic disease on surgical pathology and post-operative PET imaging.…”

Patterns of Care and Treatment Outcomes in Locoregional Squamous Cell Carcinoma of the Prostate

“…The cellular origin of prostate SCC is not well established; however, potential cells of origin include the prostatic urothelium, the periurethral ducts, basal cells within prostatic acini, and columnar prostatic cells [1] , [2] . Prostate SCC has a different presentation to the more common adenocarcinoma, often with normal prostate-specific antigen (PSA), osteolytic rather than osteoblastic metastases, younger age at presentation, and lower urinary tract symptoms (LUTS) including urinary retention [1] , [2] , [3] , [4] . Because PSA is often low at diagnosis, cases are often incidentally detected during workup and management of LUTS [1] , [2] , [4] .…”

“…Because PSA is often low at diagnosis, cases are often incidentally detected during workup and management of LUTS [1] , [2] , [4] . There are multiple case reports of primary pure prostate SCC in the literature from 1979 to 2019, treated variably with radiotherapy (RT), androgen deprivation therapy (ADT), platinum and non-platinum chemotherapy regimens, and a wide range of surgeries from transurethral resection of the prostate to pelvic exenteration [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] . Median survival (MS) has historically been poor, estimated at approximately 14 mo [6] .…”

“…The standard of care for other pelvic SCCs, including SCC of the cervix, anus, and vagina, are based around combined-modality therapy including chemotherapy, often with platinum-based chemotherapy regimens. Existing case reports support the use of platinum-based chemotherapy regimens (cisplatin/5-fluorouracil, methotrexate/peplomycin/cisplatin, bleomycin/cisplatin, among others) for SCC of the prostate [2] , [3] , [4] .…”