한국인 전이 전립선암환자에서 Flutamide 투여 후 발생한 간독성의 임상양상

Abstract

Purpose: The incidence of flutamide-related liver toxicity was studied in 56 Korean patients, treated for advanced prostate cancer with flutamide combined with a LHRH agonist or orchiectomy. Materials and Methods: Serum glutamic oxaloacetic transaminase(SGOT), serum glutamic pyruvic transaminase(SGPT), total bilirubin and alkaline phosphatase were measured to assess liver function at baseline, 1, 2 and 3 months and every 3 months thereafter. When they were elevated three-fold or more than upper normal levels, we regarded it as a presence of liver toxicity. Viral marker studies (Hepatitis B, C) were performed in patients with elevated SGOT and/or SGPT after flutamide administration. Results: Ten patients(17.9%) showed elevated SGOT and/or SGPT at an average of 3 months after flutamide administration. All patients who performed viral marker studies revealed negative results. Total serum bilirubin was elevated in three(5.4%) patients and clinical jaundice appeared in one(1.8%). All clinical and biochemical manifestations of liver toxicity disappeared within two months after discontinuation of flutamide and no sequelae was observed for 15 months. Conclusions: The incidence of flutamide-induced hepatotoxicity seems to be higher in Korea than in North America. But this might not be due to the fact that Korea is an endemic area of viral hepatitis. Further study will be necessary for the verification of dose-related toxicity of flutamide in Korean prostate cancer patients. We recommend liver function test periodically to patients treated with flutamide.