전이성 전립선암의 예후인자로서 전립선 특이항원과 혈중 전립선 산성인산효소활성도의 변화 (Change of Prostatic Specific Antigen and Prostatic Acid Phosphatase as Factors of Prognosis in Metastatic Prostate Cancer)

서지정보

· 발행기관 : 고신대학교(의대) 고신대학교 의과대학 학술지
· 수록지 정보 : 고신대학교 의과대학 학술지 / 13권 / 1호 / 91 ~ 98페이지
· 저자명 : 유소진, 정연태, 이창규, 류현열

초록

The purpose of this article was to evaluate the prognostic significance of pre- and posttreatment parameters in prostate specific antigen (PSA) and prostate acid phosphatase (PAP) in relation to the survival of patients with metastatic prostate cancer. Twenty-two patients treated with hormonal therapy for metastatic prostate cancer were evaluated for different pre- and posttherapy parameters, including a posttherapy decline in PSA and PAP of 50% and 80 % from baseline, respectively. In the univariate analysis, initial Karnofsky performance status over 80 was associated with favorable outcome (p<0.05), while age, extent of disease on bone scan, and individual sites of metastatic disease were not significant. No difference in survival was observed among patients with measurable or assessable (bone only) disease. Sixteen patients (73%) had simultaneous decline of both markers (PSA and PAP). Four (18%) patients showed discordance between two parameters. Declines in PSA level typically preceeded decreases in acid phosphatase levels. The median survival of patients showing more than fifty percents declines in both markers exceeded that of patients showing less than 50% declines in both markers by 9 months.
The results suggest that posttherapy declines in PSA and PAP represent reproducible endpoints in metastatic prostate cancer. The requirement of a repeated and parallel decline in both markers may improve the results observed by monitoring declines in PSA alone. Monitoring the two parameters may allow the developement of models that can be used as endpoints for response and survival in disease in which reproducible measurements of response are lacking.

영어초록

The purpose of this article was to evaluate the prognostic significance of pre- and posttreatment parameters in prostate specific antigen (PSA) and prostate acid phosphatase (PAP) in relation to the survival of patients with metastatic prostate cancer. Twenty-two patients treated with hormonal therapy for metastatic prostate cancer were evaluated for different pre- and posttherapy parameters, including a posttherapy decline in PSA and PAP of 50% and 80 % from baseline, respectively. In the univariate analysis, initial Karnofsky performance status over 80 was associated with favorable outcome (p<0.05), while age, extent of disease on bone scan, and individual sites of metastatic disease were not significant. No difference in survival was observed among patients with measurable or assessable (bone only) disease. Sixteen patients (73%) had simultaneous decline of both markers (PSA and PAP). Four (18%) patients showed discordance between two parameters. Declines in PSA level typically preceeded decreases in acid phosphatase levels. The median survival of patients showing more than fifty percents declines in both markers exceeded that of patients showing less than 50% declines in both markers by 9 months.
The results suggest that posttherapy declines in PSA and PAP represent reproducible endpoints in metastatic prostate cancer. The requirement of a repeated and parallel decline in both markers may improve the results observed by monitoring declines in PSA alone. Monitoring the two parameters may allow the developement of models that can be used as endpoints for response and survival in disease in which reproducible measurements of response are lacking.

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