Liver dysfunction and the treatment in combined androgen blockade for patients with prostate cancer / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the incidence of liver dysfunction and the relevant treatment in patients with prostate cancer with combined androgen blockade. Methods Twenty three patients (mean age,73 years;range,63-80 years) with histologically confirmed prostate cancer showed liver dysfunction during the course of combined blockade with bilateral orchiectomy and flutamide at a dose of 250 mg,3 times per day.After 6.2 months of therapy, ALT level was increased from pre treatment of (37?7.2)U/L to (63.5?7.53)U/L in 17 patients without jaundice and (87.2?7.34)U/L in 6 patients with jaundice.In the 17 patients without jaundice,herbal medicines were used together with vitamin C and vitamin B complex for 1-2 months (first line therapy).In the 6 severely disordered patients,flutamide was stopped, while glucurolactone at a dose of 1.2 g and (or) TAD of 0.6-1.2 g were administered intravenously per day for 4 weeks (second line therapy).Liver function was monitored every week. Results The 17 patients with mild liver dysfunction recovered after application of first line therapy for 1-2 months.The other 6 patients with relatively severe dysfunction had recovery or improvement with additional second line therapy.Of these patients,4 died of hepatic metastases after 2.1 years. Conclusions It is necessary to monitor liver function during the course of combined androgen blockade and to adopt liver protecting therapy for patients with prostate cancer who previously had hepatitis.