The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group

Bedük, Yaşar; Türkeri, Levent; ESEN, TARIK; AKDAŞ, Atıf; Bekiroglu, Nural; Eliş, Haluk; can, cavit

The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group

Yaşar BEDÜK, (Başkent Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Nural BEKİROĞLU, (Marmara Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, İstanbul, Türkiye)

Atıf AKDAŞ, (Marmara Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, İstanbul, Türkiye)

Haluk ÖZEN, (Hacettepe Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Tarık ESEN, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Üroloji Anabilim Dalı, İstanbul, Türkiye)

Cavit CAN, (Osmangazi Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Eskişehir, Türkiye)

Levent TÜRKERİ (Marmara Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, İstanbul, Türkiye)

Marmara Medical Journal

2 0

Yıl: 2007 Cilt: 20 Sayı: 2 Sayfa Aralığı: 75 - 84 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group

Öz:

Amaç: İlerlemiş prostat kanserinde tibbi veya cerrahi kastrasyon ile CPA’yi karşılatırmak ve CPA’nin terapötik etkisini ortaya koymak. Gereç ve Yöntem: 19 Üroloji Merkezi’ne başvuran T1-4N+MX veya T1-4NXM+ evreli prostat adenokanserli hastalar çalışmaya alınmıştır. Toplam 120 hasta, CPA 3X100mg/gün (Grup1) ve tıbbi veya cerrahi kastarasyon (Grup 2) gruplarına rastgele dağıtılmışlardır. Bu denemenin birincil son noktaları genel ve hastalığa-özel sağkalım olasılıklarıdır. Progresyonsuz sağkalım (PSA progresyon zamanı) ve testesteron düşüş hızı ikincil son noktalar olarak kabul edilmiştir.Progresyonsuz sağkalım olasılıkları Kaplan-Meier metoduyla hesaplanmış ve Logrank testiyle de sağkalım olasılıkları karşılaştırılmıştır.Sonuçlar: Başlangıçta her iki grupta da PSA ortanca(medyan) değerleri 42ng/dl bulunmuş ve 3 ayda Grup1’de 3.0 ‘e Grup2’de de 2.1’e düşmüştür (p>0.05). Her iki grupata 3 aylık bir tedavi sonrasındaki testesteron seviyeleri başlangıçtaki değerlerin Grup1’de % 9’una Grup2’de %6.7’sine ulaşmıştır (p>0.05).Her ne kadar veriler sağkalım süreleri için tam olmasa bile, ortanca 24 aylık izlem süresinde PSA-progresyonu için iki grup sağkalımlarında bir fark bulunmamıştır (p=0.616).Sonuç: Yaptığımız bu randomize çalışma, CPA ve kastrasyon tedavisi alan prostat kanserli hastalarda progresyonsuz sağkalım bakımından 24 aylık izlem zarfında herhangi bir anlamlı faklılık ortaya koymamıştır. Monoterapinin başlangıçtaki etkinliği ve tolerabl olması bu terapinin kabul edilebilir ve güvenilir bir tedavi olduğu yorumlarında bizi cesaretlendirmektedir.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Metastatik prostat kanserinde cyproterone acetate ve kastrasyon monoterapilerinin etkinliğinin karşılaştırması: Çok merkezli bir türk üro-onkoloji grubu çalışması

Öz:

Objective: To detect therapeutic efficacy of CPA and to compare it with those of surgical or medical castration in advanced prostate cancer Patients and Methods: Patients from 19 Urology Centers with prostate adenocarcinoma of stages T1-4N+MX or T1-4NXM+ were enrolled.Total of 120 patients were randomized to receive CPA 3X100mg/d(Group 1) versus medical or surgical castration(Group 2).The primary endpoints for this trial were overall and disease-spesific survival.Progression-free survival(PSA progression time) and testosterone decrease rate were assessed as secondary endpoints.Progression-free survival probabilities were calculated by Kaplan-Meier method and comparison of survival probabilities was performed by Logrank test.Results: Median PSA values were 42ng/dl in both groups at initiation and decreased to 3.0 and 2.1 respectively in 3 months(p>0.05).Castrate testosterone levels were reached in two groups after 3 months therapy( 9% and 6.7% of initial values respectively;p>0.05).The data is immature to assess the survival durations,but in median follow-up of 24 months,no difference in regard to PSA-progression was detected in two groups(p=0.616).Conclusion: This randomized study of CPA and castration in patients with metastatic prostate cancer didn’t reveal any significant differences in progression-free survival so far.The initial efficacy and tolerability of monotherapy encourages us to comment that this therapy is safe and acceptable.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Bedük Y, Bekiroglu N, AKDAŞ A, Eliş H, ESEN T, can c, Türkeri L (2007). The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. , 75 - 84.
Chicago	Bedük Yaşar,Bekiroglu Nural,AKDAŞ Atıf,Eliş Haluk,ESEN TARIK,can cavit,Türkeri Levent The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. (2007): 75 - 84.
MLA	Bedük Yaşar,Bekiroglu Nural,AKDAŞ Atıf,Eliş Haluk,ESEN TARIK,can cavit,Türkeri Levent The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. , 2007, ss.75 - 84.
AMA	Bedük Y,Bekiroglu N,AKDAŞ A,Eliş H,ESEN T,can c,Türkeri L The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. . 2007; 75 - 84.
Vancouver	Bedük Y,Bekiroglu N,AKDAŞ A,Eliş H,ESEN T,can c,Türkeri L The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. . 2007; 75 - 84.
IEEE	Bedük Y,Bekiroglu N,AKDAŞ A,Eliş H,ESEN T,can c,Türkeri L "The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group." , ss.75 - 84, 2007.
ISNAD	Bedük, Yaşar vd. "The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group". (2007), 75-84.

APA	Bedük Y, Bekiroglu N, AKDAŞ A, Eliş H, ESEN T, can c, Türkeri L (2007). The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. Marmara Medical Journal, 20(2), 75 - 84.
Chicago	Bedük Yaşar,Bekiroglu Nural,AKDAŞ Atıf,Eliş Haluk,ESEN TARIK,can cavit,Türkeri Levent The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. Marmara Medical Journal 20, no.2 (2007): 75 - 84.
MLA	Bedük Yaşar,Bekiroglu Nural,AKDAŞ Atıf,Eliş Haluk,ESEN TARIK,can cavit,Türkeri Levent The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. Marmara Medical Journal, vol.20, no.2, 2007, ss.75 - 84.
AMA	Bedük Y,Bekiroglu N,AKDAŞ A,Eliş H,ESEN T,can c,Türkeri L The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. Marmara Medical Journal. 2007; 20(2): 75 - 84.
Vancouver	Bedük Y,Bekiroglu N,AKDAŞ A,Eliş H,ESEN T,can c,Türkeri L The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group. Marmara Medical Journal. 2007; 20(2): 75 - 84.
IEEE	Bedük Y,Bekiroglu N,AKDAŞ A,Eliş H,ESEN T,can c,Türkeri L "The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group." Marmara Medical Journal, 20, ss.75 - 84, 2007.
ISNAD	Bedük, Yaşar vd. "The comparison of the efficacy of cyproterone acetate and castration monotherapies in metastatic prostate cancer: A multicenter study of Turkısh uro-oncology group". Marmara Medical Journal 20/2 (2007), 75-84.