전이성 거세저항성 전립선암 환자의 치료 편집하기 (부분)

== 근거표 ==
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!KQ20
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!Reference
| 1. Sørensen S, Helweg-Larsen S, Mouridsen H, et al. Effect of high-dose dexamethasone in carcinomatous metastatic spinal cord compression treated with radiotherapy: a randomised trial. Eur J Cancer 1994;30A:22-7.
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!Study type
|Randomised prospective study
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!Patients
| Patients with solid tumors with metastatic spinal cord compression treated with radiotherapy
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!Purpose of Study
|To evaluate the efficacy of high-dose dexamethasone as an adjunct to radiotherapy in patients with metastatic spinal cord compression from solid tumours
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!Study Results
| A successful treatment result defined as gait function after treatment was obtained in 81% of the patients treated with dexamethasone compared to 63% of the patients receiving no dexamethasone therapy. Six months after treatment, 59% of the patients in the dexamethasone group were still ambulatory compared to 33% in the no dexamethasone group. Life table analysis of patients surviving with gait function showed a significantly better course in patients treated with dexamethasone (P<0.05). Median survival was identical in the two treatment groups. Similar results were found in subgroup analysis of 34 patients with breast cancer as the primary malignancy.
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!Level of Study
|1
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!Reference
| 2. Graham PH, Capp A, Delaney G et al. A pilot randomized comparison of dexamethasone 96 mg vs 16 mg per day for malignant spinal-cord compression treated by radiotherapy: TROG 01.05 Superdex study. Clin Oncol (R Coll Radiol) 2006;18:70-6.
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!Study type
| Randomised prospective study
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!Patients
| Patients with malignant spinal-cord compression with evidence from magnetic resonance imaging, and at least one of pain, weakness, sensory symptoms or sphincter disturbance symptoms.
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!Purpose of Study
| To test the viability of a full-scale randomised comparison of two steroid doses given with radiotherapy for malignant spinal-cord compression (MSCC), to test Internet randomisation and to compare different functional outcome measures. 
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!Study Results
| At baseline, 75% were ambulant, 70% had FIM ambulation scores greater than 5 and 50% had Barthel Index ambulation scores greater than 2. At day 28, including all randomised patients (by scoring four dead patients as non-ambulant), ambulation scores by the various definitions were 60%, 45% and 40%, respectively. For the 16 patients evaluable at day 28, the mean FIS was -1.4. Median survival was 69 days and 1-year survival 13%. Choice of measure of ambulation has potentially significant effects on outcomes and implications for the design of any future MSCC trials.
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!Level of Study
|1
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!Reference
| 3. Vecht CJ, Haaxma-Reiche H, van Putten WL, de VM, Vries EP, Twijnstra A. Initial bolus of conventional versus high-dose dexamethasone in metastatic spinal cord compression. Neurology 1989;39:1255-7.
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!Study type
|Randomised prospective study
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!Patients
|Patients with metastatic spinal cord compression
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!Purpose of Study
| To evaluate the efficacy of high-dose dexamethasone in patients with metastatic spinal cord compression. 
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!Study Results
| The average pain score before the start of treatment was 5.2 (SD=2.8) and decreased significantly (p less than 0.001) to 3.8 at 3 hrs, 2.8 at 24 hrs, and 1.4 after 1 week. There were no differences between the conventional and high-dose group on pain, ambulation, or bladder function.
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!Level of Study
|1
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