İnanç İMAMOĞLU, Nevzat Can ŞENER, İ. Halil BOZKURT, İsmail NALBANT, Orhan YİĞİTBAŞI, Kürşad ZENGİN

Kastrasyon Dirençli Prostat Kanserli Hastalarda Dosetaksel Tedavisi Öncesi ve Sonrası CRP ile PSA Değerlerinin Kıyaslanması

Amaç: Kanserin inflamasyonu indüklediği hipotezinden yola çıkılarak, bu süreçte rol alan belirteçlerin kanser ileilişkisi uzun zamandır pek çok çalışmaya konu olmuştur. İnflamatuar belirteçlerden C-Reaktif proteinin (CRP) pros- tat kanserinin prognozunu öngörebileceğine dair pek çok yayın bulunmaktadır. Kliniğimizde 2010 yılından itibarenkastrasyon dirençli prostat kanseri (KDPK) tanısı almış ve dosetaksel tedavisi başlanan prostat kanserli hastalarıntedaviye başlanmadan önceki ve 8 kür tedavi sonrası CRP düzeyleri ile prostat spesifik antijen (PSA) retrospektifolarak dosyaları araştırılarak kıyaslanmıştır.Yöntem ve Gereçler: KDPK tanısı ile dosetaksel tedavi protokolüne alınan ve 8 kür tedavi verilmesi planlanan 55hasta dosyası araştırılmıştır. Hastaların 3 tanesinin tedavi protokolünü tamamlayamadan komorbid faktörlere bağlıex olduğu görülmüştür. Tedavi protokolünü tamamlayan 52 hastanın verileri ile istatistiksel çalışma yürütülmüştür.Hastaların ortalama yaşam süreleri hesaplanmıştır. Hastaların tedavi öncesi CRP ve PSA değerleri tedavi sonrasıdeğerleri ile kıyaslanmıştır.Bulgular: Hastaların ortalama takip süresi 16.6 aydır (9-40 ay). Hastaların tedavi öncesi PSA ortalaması 82.9 ng/mL(12-150) olarak bulundu. Tedavi öncesi ortalama CRP değeri ise 10.6 mg/dL (3-75) olarak hesaplandı. Hastaların22'sinin (%42.3) tedavi öncesi CRP değeri normal seviyede iken, 30'unun (%57.7) CRP değeri yüksekti.Tedavi sonrası ortalama CRP değeri 8.09 mg/dL (3-65) iken ortalama PSA değeri ise 41.76 ng/mL (1.3-150) olarakhesaplanmıştır. Tedavi öncesi ve sonrası CRP değerleri kıyaslandığında anlamlı bir sonuç bulunmazken (p=0.24),PSA için istatiksel açıdan anlamlı bir fark olduğu görülmüştür (p=0.047). Tedavi sonrası 17 hastanın (%32.7) CRPdeğeri normal düzeyde izlenmiş, 8 hastanın (%15.4) CRP düzeyi artmış, ve 27 hastanın (%51.9) CRP düzeyinin iseazalmış olduğu görülmüştür. Çalışmaya alınan hastaların ortalama yaşam süresi 13.2 ay (8-40 ay) olarak hesaplan- mıştır.Sonuç: Çalışmamızda PSA değerleri KDPK'li hastaların kemoterapi esnasında ve sonrasında izlenmesi açısındanCRP'den daha değerli bulunmuştur.

Comparison of Pre And Post Treatment CRP And PSA In Patients With Castration Resistant Prostate Cancer Under Docetaxel Treatment

Introduction: Having the hypothesis of cancer originating from inflammation, various authors searched whetherinflammatory markers were involved in cancer process. C-reactive protein (CRP) has been researched many timesto foresee prostate cancer outcome. In this study, we aimed to evaluate the data of CRP and prostate specific antigen(PSA) levels of Castration Resistant Prostate Cancer (CRPC) patients treated with 8 cycles of docetaxel before andafter treatment in our clinic between 2010-2013 and compare whether they have an effect on performance status. Material and Methods: Files of 55 patients in docetaxel protocol and aimed to manage by 8 cycles were analyzed.Three of these patients died by accompanying factors. The remaining 52 patients were included in the study. MeanCRP and PSA values before and after treatment were compared according to performance status.Results: Mean follow-up duration was 16.6 months (9-40 months). Pre-treatment mean PSA and CRP were 82.9ng/mL (12-150) and 10.6 mg/dL (3-75), respectively. 22 of these patients (42.3%) had normal CRP and 30 patients(57.7%) had elevated CRP. Post-treatment CRP and PSA were 8.09 mg/dL (3-65) and 41.76 ng/mL (1.3-150), respec- tively. Even though CRP levels before and after treatment did not differ (p=0.24), PSA rise was statistically significant(p=0.047). CRP of 17 patients (32.7%) was normal, 8 patients (15.4%) were elevated and 27 patients (51.9%) werediminished. Mean survival was 13.2 months (8-40). Conclusion: Serum PSA was more worthy than CRP in the follow-up of CRPC patients.

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