호르몬 저항성 전립선암에서 Ketoconazole-prednisolone 병용요법과 Prednisolone 단독요법의 비교

Abstract

Purpose: We compared the effects of ketoconazole-prednisolone combination therapy with prednisolone alone in patients with hormone refractory prostate cancer. Materials and Methods: A total of 21 consecutive patients with hormone refractory progressive prostate cancer were included in this retrospective study. Eleven patients were treated with 5mg of prednisolone orally two or three times a day and ketoconazole 200mg orally three times a day and 10 patients were treated with prednisolone alone. Serum PSA decline, survival benefit, changes of performance status and pain intensity were compared between combination and prednisolone alone group. Results: The mean and median PSA decline after treatment was 23%, 25% in combination group and 38%, 34% in prednisolone alone group. Three patients (27%) had a PSA decline of more than 50% in combination group and 3 patients (30%) in prednisolone alone group. The average and median time for progression free survival were 5.2, 4.0 months and 6.0, 5.5 months, respectively. There was no statistical difference of PSA decline, progression free survival, actuarial survival, change of performance status and pain intensity between combination and prednisolone alone group. There were less side effects in prednisolone alone group. Conclusions: Ketoconazole-prednisolone combination and prednisolone alone had a beneficial effect in hormone refractory prostate cancer, clinically and in terms of PSA response. There was no statistical evidence that one treatment is better than the other, although palliative effects may well be in favor of alone group including less side effects. Key word : Hormone refractory prostate cancer, Prednisolone, Ketoconazole, PSA