Lokal İleri Evre Prostat Kanserinde Maksimal Androjen Blokaj Tedavisinin Hematolojik, Biyokimyasal Ve Kemik Yoğunluğu Parametreleri Üzerine Etkileri

Yıl 2018, Cilt: 2 Sayı: 3, 182 - 187, 13.11.2018

Erhan Demirelli Ahmet Hakan Haliloğlu Ömer Gülpınar Mehmet Giray Sönmez Yaşar Bedük Sadettin Küpeli

https://doi.org/10.30565/medalanya.407858

Öz

Amaç: Bu çalışmanın amacı, lokal olarak ilerlemiş
prostat kanserinde maksimal androjen blokajı
tedavisinin (MABT) hemoglobin (Hb) ve hematokrit (Htc) değerleri ile açlık kan
şekeri (AKŞ), serum lipid değerleri ve kemik mineral yoğunluğu (KMD)
üzerindeki  etkisini kontrol etmektir.

Hastalar ve Yöntemler: MABT ile tedavi edilen 39 hastanın
başlangıç ve onikinci aydaki hemoglobin, hematokrit, açlık kan şekeri, total
kolesterol (tChol), trigliserit (TG), yüksek yoğunluklu lipoprotein (HDL),
düşük yoğunluklu lipoprotein (LDL) ve omurga KMD değerleri kaydedildi. İlk ve
onikinci aydaki değerlerin istatistiksel karşılaştırmaları yapıldı.

Bulgular:  Bir
yıllık MABT sonrası Hb ve KMD değerlerinde istatistiksel olarak anlamlı azalma
kaydedildi. Öte yandan, TG, tChol, LDL, HDL ve AKŞ değerleri istatistiksel olarak
anlamlı bir artış gösterdi. Hb düzeyleri önemli ölçüde azalmış olmasına rağmen,
hastalarımızın hiçbirinde anemi belirtileri gelişmedi. Tedaviden önce FBG
seviyeleri 110 mg / dl'nin altında olan 37 hastanın 14'ü tedavinin onikinci
ayında 110 mg / dl'nin üzerine çıktı. Yedi hastada tedaviden sonra diyabetes
mellitus (DM) gelişti. Dahası, T skoru değerlendirmesi 4 hastada yeni gelişen
osteoporozu ortaya koymuştur. Osteoporoz gelişen tüm hastaların tedaviden önce
osteopenik T skoru değerleri vardı. Hiç bir hastamızda kemik kırığı oluşmadı.

Sonuç:
Çalışmamız MABT bağlı AKŞ artışını göstermektedir. KMD değerindeki azalma, daha
önce osteopenik olan hastalarda daha yüksektir. Kemik kırığı ve anemi
semptomlarının olmaması, MABT ile ilgili erken verilerin değerlendirilmesinin
bir sonucu olarak düşünülebilir   

Anahtar Kelimeler

Prostat kanseri, Maksimal Androjen Blokajı, Kemik mineral dansitesi, Lipit profili

Effect of maximal androgen blockade therapy on hematological, biochemical and bone density in locally advanced prostate cancer

Öz

Aim: In the present study we aimed to check the
impact of maximal androgen deprivation therapy (MADT) on cellular blood
components such as hemoglobin (Hb) and hematocrit (Htc)  fasting blood glucose (FBG), serum lipid values
and bone mineral density (BMD) in locally advanced prostate cancer.

Patients and Methods: Having been treated with maximal
androgen blockade therapy, thirty-nine patients' initial values and at the
twelfth month values of hemoglobin (Hb), hematocrit (Htc), FBG, total
cholesterol (tChol), triglyceride (TG), high density lipoprotein (HDL), low density
lipoprotein (LDL) and spine BMD were recorded. Statistical comparisons of
initial and at the twelfth month values were performed. 

Results:  A
statistically significant decrease was recorded in Hb and BMD values after one
year MADT. On the other hand, TG, tChol, LDL, HDL and FBG values showed a
statistically significant increase. Although Hb levels were significantly
reduced, none of our patients developed symptoms of anemia. Fourteen of 37
patients whose FBG levels were under 110 mg/dl before treatment, increased over
110 mg/dl at the twelfth month of treatment. Seven patients developed diabetes
mellitus (DM) after treatment. Moreover, T score evaluation revealed newly
developed osteoporosis in 4 patients. All of the patients with developed osteoporosis
had osteopenic T score values before treatment. No bone fractures occurred in
any of our patients.

Conclusion:
Our study points out the increase of FBG related to the treatment of MADT.
Decrease in BMD is higher in previously osteopenic patients. The lack of bone
fracture and anemia symptoms might be considered as a result of evaluation of
the early data on MADT.

Anahtar Kelimeler

Prostate cancer, Maximal androgen blockade, Bone mineral density, Lipid profile

Kaynakça

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