전립선암의 병용 안드로젠차단요법의 임상적 반응

Abstract

Purpose: In Korea, there has not been a comparative study in terms of treatment methods of metastatic prostate cancer and the matter is still under investigation. We analyzed the results of CAB and tried to elucidate the clinical course of those who underwent CAB.Materials and Methods: 60 metastatic prostate cancer patients who underwent CAB from March 1991 to July 1997 and who were eligible to follow up for at least 6 months were enrolled in this study. The interval to conversion to hormonal refractory prostate cancer (HRPC) after CAB, the interval to death after conversion to HRPC and survival curve were analyzed according to initial Gleason`s score and PSA level.Results: Mean patient age was 67.2 years and mean follow-up duration was 25.4 months(6-62). During the follow-up period, 30 patients(50%) showed rise of PSA, 5(17%) of whom revealed steroid withdrawal syndrome and the remaining 25 patients were converted to HRPC. The mean interval to conversion was 18.2 months(4-43). 12 patients died and mean interval from conversion to HRPC to death was 12.2 months(5-24) and the mean survival duration after CAB of the patients who died was 28.2 months(11-53). The mean survival duration was 41.9 months(6-62). The overall(actuarial) survival rates of the whole patients were 86.2%, 65.2% and 38.4% in 2 years, 3 years and 5 years, respectively. There was no correlation between the initial PSA level and conversion to HRPC(p>0.05) but the higher the Gleason`s score was, the more likely the patient was to be converted to HRPC(p<0.05). Conclusions: In metastatic prostate cancer, initial PSA was not a predictive factor for response to CAB. But, higher initial Gleason`s score significantly correlated with higher conversion rate to HRPC. Within the limits of this study, one can at least assume that CAB is not inferior to monotherapy in its clinical results.