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.
In this study : 30 patients with metastatic prostate cancer who admitted to the
department of Oncology, Tishreen University Hospital, Lattakia, Syria between 2013
and 2014 were grouped according to gleason score , age and body mass index.
All pati
ent received treatment with LHRH agonist (goserelin 3,6 mg
subcutaneous injection monthly) combined with anti-androgen for two weeks.
PSA and testosterone were measured in all patients before treatment then after 1
and after 6 month and the side effects were documented.
Results post ADH treatment:
There is no relationship between body mass index and testosterone level.
Hormonal treatment with LHRH agonist reduced testosterone to 50 ng/dl in 09% of the
patients, whereas 76%of the cases achieved testosterone levels 20ng/dl.
The most common treatment-related adverse event was depression 72% , hot flash
%33 and headache 30%.
Radical cystectomy is the most effective therapeutic approach for patients with
muscle-invasive bladder cancer. Due to the incidence of sexual and continence complications associated
with this procedure, alternative techniques such as cystectomy wi
th partial prostatectomy have been
described in selected cases in order to reduce complications.
To evaluate the possible oncological risks of prostate-sparing cystectomy, and to determine the associated
pathological findings in the prostate for patients with invasive bladder cancer treated by radical
cystoprostatectomy.
