Patients should have achieved stable analgesia for 7 days
Karnofsky Performance Status ≥ 70
No prior treatment with cytotoxic agent (except estramustine)
Normal cardiac function must be confirmed by Left ventricular ejection fraction
Adequate organ function:
1. Hematology:
* Neutrophils \> 1.5 x 10\^9/L
* Hemoglobin \> 10 g/dl. Erythropoietin use is allowed, but red blood cell transfusion to upgrade the hemoglobin level is not allowed
* Platelets \> 100 x 10\^9/L
2. Hepatic function:
* Total bilirubin \< the upper-normal limit of the institution.
* Alanine aminotransferase and Aspartate transaminase \< 1.5 times the upper-normal limit of the institution.
3. Renal function:
* Creatinine \< 1.5 times the upper normal limit (ie National Cancer Institution grade \< 1)
No brain or leptomeningeal metastases
You may not be if
Prior radiotherapy to \>25% of bone marrow (whole pelvic irradiation is not allowed)
prior cytotoxic chemotherapy, except monotherapy with estramustine
prior isotope therapy
history of another cancer within the preceding five year
symptomatic peripheral neuropathy grade ≥ 2
other serious illness or medical condition:
1. Congestive heart failure even if controlled. Previous history of myocardial infarction or angina pectoris within 1 year from study entry, uncontrolled hypertension or uncontrolled arrhythmias.
2. Active uncontrolled infection
3. Peptic ulcer, unstable diabetes mellitus or other contraindications for the use of corticosteroids.
