Comparison of Ketoconazole and Estramustine for Treating Patients with Castration-Resistant Prostate Cancer
윤부현, 황의창, 유동훈, 황인상, 김선옥, 정승일, 강택원, 권동득, 박광성, 류수방,
소속 상세정보
윤부현 ( Yun Bu-Hyeon )
Chonnam National University Medical School Department of Urology
황의창 ( Hwang Eu-Chang )
Chonnam National University Medical School Department of Urology
유동훈 ( Yoo Dong-Hoon )
Chonnam National University Medical School Department of Urology
황인상 ( Hwang In-Sang )
Chonnam National University Medical School Department of Urology
김선옥 ( Kim Sun-Ouck )
Chonnam National University Medical School Department of Urology
정승일 ( Jung Seung-Il )
Chonnam National University Medical School Department of Urology
강택원 ( Kang Taek-Won )
Chonnam National University Medical School Department of Urology
권동득 ( Kwon Dong-Deuk )
Chonnam National University Medical School Department of Urology
박광성 ( Park Kwang-Sung )
Chonnam National University Medical School Department of Urology
류수방 ( Ryu Soo-Bang )
Chonnam National University Medical School Department of Urology
KMID : 0358320110520110746
Abstract
Purpose:We investigated the efficacy of ketoconazole and estramustine before chemotherapy for treating patients with progressive castration-resistant prostate cancer (CRPC) after anti-androgen withdrawal syndrome.
Materials and Methods :Eighty-four patients who were diagnosed with CRPC and were treated between 2005 and 2009 were included. Thirty-nine patients were treated with 600 mg of ketoconazole and 10 mg of prednisolone per day (group I), and 45 patients were treated with 560 mg of estramustine per day (group II). The prostate-specific antigen (PSA) response, progression-free survival, and side effects were compared.
Results:The median age of the patients, PSA level, and follow-up period were 72 years, 48.5 ng/ml, and 4 months (range, 1 to 29 months), respectively. The overall PSA response rate was 35.7%, and the PSA response rates were 33.3% for group I and 37.8% for group II (p=0.672). The median progression-free survival times were 8 months (95% confidence interval [CI] 5.9-10.1) overall, 5 months (95% CI 1.6-8.3) in group I, and 8 months (95% CI 5.9-10.0) in group II (p=0.282). The most common complications in groups I and II were nausea and vomiting (51.3%) and anemia (77.8%), respectively. Nausea and vomiting and hepatotoxicity were observed more often in group I, and gynecomastia, neutropenia, and anemia were observed more often in group II. The toxicities of each adverse effect were ≤grade 2.
Conclusions:With a resultant PSA decline and mild adverse effects, both ketoconazole and estramustine are worth consideration as treatment options for progressive CRPC patients after primary hormonal therapy.
키워드
Estramustine; Ketoconazole; Prostatic neoplasms
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