Background: low –dose ketoconazole (LDK) in combination with steroids has been
recognized as an effective secondary hormonal therapy in androgen-independent prostate
cancer (AIPC), we hypothesized that low-dose ketoconazole would likewise possess
efficacy and tolerabilitiy in the (AIPC).
Methods: in a single institution (Tishreen University Hospital, Lattakia), patients
with AIPC treated with LDK (at a dose of 200 mg orally 3 times daily ) as secondary
hormonal therapy with concomitant steroids were retrospectively identified, After
experiencing a rising prostate –specific antigen (PSA) level.
Results: 21 of 50 eligible patients)42%) treated with LDK experienced PSA declines
≥ 50% after the start of treatment, while there were 12 patients with low PSA between 25-
50% with a median duration of response (5.4 months) 7 patients less than 25 % decrease,
while 10 patients did not never respond. The most common complications is the fatigue
and general debility in 18 patients , digestive disorders in 21 patients (Summit, nausea and
diarrhea) , muscle disorders in 3 patients, and Metabolic disorders in five patients The
incidence of drug toxicity grade 3-4 is very few. There were only three patients not able to
continue the treatment due to severe side effects.
Conclusion: low dose ketokonazole and Predenisolone is a well – tolerated, relatively
inexpensive and clinically active treatment option. PSA response to low – dose
ketoconazole historically comparable to that of Abiraterone in patients with AIPC.
يعد السرطان من أهم الأمراض المسببة للوفاة في جميع أنحاء العالم حيث سجل ما يقارب 14 مليون حالة إصابة جديدة و8.2 مليون حالة وفاة في عام 2012 ومن المتوقع أن يرتفع عدد الاصابات بمعدل 70% خلال العقدين القادميين
