The present retrospective, single‑centre study investigated the efficacy and toxicity of upfront docetaxel chemotherapy in patients with hormone‑sensitive metastatic prostate cancer and evaluated the impact in high and low‑volume disease. Data from 167 patients with hormone‑sensitive metastatic prostate cancer treated between January 2016 and December 2019 were analysed. The data cut‑off was February 2024; the median follow‑up time was 37 months and the median age was 66 years. The cohort consisted of varying Gleason scores, with the majority scoring 9 (n=86; 51.1%). Surgical castration was performed in the majority of cases (n=136; 81.4%). Overall, 66 (39.5 %) of the patients had low‑volume disease (≤5 sites of metastasis, no visceral metastasis), while 101 (60.5%) patients had high‑volume disease. Disease progression occurred in 100 patients (59.9%), with a median progression‑free survival (PFS) of 47 months (95% CI, 37.503‑56.497). The median overall survival (OS) was 71 months. In the comparison of low‑volume vs. high‑volume disease groups, the median PFS was 57 vs. 47 months respectively (P=0.276) and the corresponding median OS was not reached vs. 57 months respectively (P=0.192). Among the 100 patients with disease progression, 20 received second‑line therapy. The median OS for untreated patients was 9.88 months, while those treated with antiandrogens was 15.14 months and those with re‑challenge chemotherapy was 12.46 months (P=0.496; 95% CI, ‑6.47‑11.83). Grade 3‑4 treatment‑related toxicities were observed in ~37.8% of patients, while one death was associated with chemotherapy‑related neutropenic sepsis. The most common toxicities were mucositis (n=53; 31.7%), febrile neutropenia (n=44; 26.3%) and sepsis (n=29; 17.4%). The present study demonstrated that upfront docetaxel chemotherapy may be an effective and tolerable treatment for hormone‑sensitive metastatic prostate cancer, particularly in settings where access to novel antiandrogens is limited, thus potentially offering a viable management strategy amidst resource constraints.

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