Influence of hormonal therapy on the level of prostate specific antigen in patients with advanced prostatic cancer

% Karcinomi prostate % Antagonisti androgena % Kastracija % Testosteron % Luteinizirajuci hormone AB Introduction. The aim of this study was to investigate the influence of androgen blockades on prostate specific antigen (PSA) values in patients with locally advanced and metastatic prostatic cancer. Material and methods. The research was conducted on 60 patients. The group of 45 patients with prostatic cancer was divided into 3 subgroups, based on the type of the applied treatment protocol (15 patients on monotherapy with luteinizing hormone-releasing hormone agonists, 15 patients on total androgen blockade and 15 patients on monotherapy with antiandrogen). The control group consisted of 15 patients with benign prostatic hyperplasia. For all patients, the values of testosteron, luteinizing hormone and prostate specific antigen were monitored before as well as after 3 and 6 months during the treatment protocol. Results. All types of the applied treatment protocols in the therapy of prostatic cancer decreased the values of prostate specific antigen significantly The application of total androgen blockade and monotherapy with luteinizing hormone-releasing hormone agonists decreased the levels of prostate specific antigen significantly in comparison with monotherapy with antiandrogen. Conclusion. Although prostate specific antigen is not a prostatic cancer specific parameter, the dynamics of its decrease during the therapy of androgen blockade represents a significant marker of the therapy effect. Cilj rada je bio da se ispita uticaj androgenih blokada na vrednosti prostata specificnog antigena kod bolesnika sa lokalno uznapredovalim i metastatskim karcinomom prostate. Ispitivani uzorak se sastojao od 60 bolesnika. Grupa od 45 bolesnika sa karcinomom prostate bila je podeljena na tri podgrupe, u zavisnosti od primenjenog terapijskog protokola (15 bolesnika na monoterapiji agonistima luteinizirajuceg rilizing hormona, 15 bolesnika na totalnoj androgenoj blokadi i 15 bolesnika na monoterapiji antindrogenom). Kontrolnu grupu cinilo je 15 pacijenata sa benignom hiperplazijom prostate. Svim pacijentima su pracene vrednosti testosterona, luteinizirajuceg hormona i prostata specificnog antigena neposredno pre, kao i tri, to jest sest meseci nakon uvodjenja odgovarajuceg protokola. Sve tri vrste primenjenih terapijskih protokola u lecenju karcinoma prostate statisticki su znatno snizavale vrednosti prostata specificnog antigena u odnosu na pocetne vrednosti. Primena totalne androgene blokade i monoterapije agonistima luteinizirajuceg rilizing hormona dovela je do statisticki znatnog snizenja vrednosti prostata specificnog antigena u poredjenju sa monoterapijom antiandrogenom. Iako prostata specificni antigen nije specifican marker za karcinom prostate, dinamika njegove promene u toku androgene blokade predstavlja bitan pokazatelj terapijskog efekta.