معدلات البقيا عند مرضى سرطان الموثة المتقدم المعالجين باستئصال الخصيتين مع مضاد اندروجين " دراسة مقارنة مع الأدب الطبي "
Abstract
أجريت الدراسة في مستشفى الأسد الجامعي باللاذقية بين عامي 5/ 1999و 5/ 2003 وشملت 67 مريضاً مصابا بسرطان موثة متقدم, تراوحت أعمارهم بين 50 و89 سنة )متوسط العمر 71 سنة). عولج هؤلاء المرضى باستئصال الخصيتين مع مضاد اندروجين < ciproteronacetate>. تراوحت قيم الـ PSA بين 60 ناغ/مل و300 ناغ/مل وكان وسطياً 119 ناغ/مل وعند 60% من المرضى كان بين 100 و149 ناغ/مل. قدرت المرحلة سريرياً فكانت T3b عند64% وT3a عند 36%, أما درجة الورم المأخوذة عن طريق التشريح المرضي للخزعة الموجهة بالإصبع فكانت سيئة التميز G3 عند 81% ومتوسطة التميز G2 عند 19%. لقد وجدت نقائل عظمية عند 27% من المرضى عند التشخيص.
كان معدل البقيا في دراستنا لـ 2 و4 و5 سنوات 31% و12% و7% على الترتيب ,بينما كانت نسب البقيا في الدراسات العالمية سواء التي أضافت إلى استئصال الخصيتين مضادات الاندروجين أم لا 56% و22% و4% على الترتيب عند إعطاء الفلوتاميد بينما كانت 55% و19% و3% على الترتيب عند إعطاء دواء وهمي.
The trial was performed in Al-assad University Hospital and included 67 patients with advanced prostate cancer. The age was between 50–89 years (range71 years). The patients were treated with orchidectomy and antiandrogen {ciproteronacetat}. PSA values ranged between 60ng/ml and 300ng/ml and averagely 119 ng/ml. In 60% of patients the PSA was between 100 ng/dl and 149 ng/ml. Clinically, the stage was T3b in 64% and T3a in 36%. According to finger-guided biopsy, the grade was poor G3 in 81% and intermediate G2 in 19%. We discovered bony metastasis in 27% at diagnosis. The survival rate in our study for 2, 4, 5 years was 31%, 12% and 7% respectively. In the universal studies which have performed Orchidectomy with or without antiandrogen drug, the rate was 56%, 22% and 4% respectively with flutamid while it was 55%, 19% and 3% respectively with placebo.
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