Duration of androgen deprivation therapy and nadir of testosterone at 20 ng/dL predict testosterone recovery to supracastrate level in prostate cancer patients who received external beam radiotherapy.
Duration of androgen deprivation therapy and nadir of testosterone at 20 ng/dL predict testosterone recovery to supracastrate level in prostate cancer patients who received external beam radiotherapy.
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雄激素剥夺治疗的持续时间和睾酮最低水平为 20 ng/dL 预测接受外照射放疗的前列腺癌患者睾酮恢复至去势上水平。
DOI：
10.1111/iju.13521
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Ichikawa T.
中科院分区：
文献类型：
--
作者：
Takei A;Sakamoto S;Wakai K;Tamura T;Imamura Y;Xu M;Maimaiti M;Kawamura K;Imamoto T;Komiya A;Akakura K;Ichikawa T.
ObjectivesTo determine the predictors of testosterone recovery after termination of androgen deprivation therapy in high/middle-risk prostate cancer patients receiving external beam radiation therapy with neoadjuvant and adjuvant androgen deprivationtherapy.MethodsA total of 82 patients who received external beam radiation therapy with androgen deprivation therapy for prostate cancer were retrospectively analyzed.研究了雄激素剥夺治疗终止后的血清睾酮水平。考克斯比例风险模型和Kaplan-Meier方法进行了统计分析。ResultsMedian age，基线睾酮，最低睾酮和雄激素剥夺治疗的持续时间分别为73年，456 ng/dL，16 ng/dL和26个月。雄激素剥夺治疗持续时间33个月（风险比0.13;P= 0.0018），睾酮最低值为20 ng/dL（风险比0.35;P= 0.0112）和雄激素剥夺治疗终止后6个月睾酮>50 ng/dL（风险比0.21;P= 0.0075）在多变量分析中与睾酮恢复至正常水平（200 ng/dL）显著相关。多变量分析显示，雄激素剥夺治疗持续时间为33个月（风险比0.31;P= 0.0023）和睾酮最低值为20 ng/dL（风险比0.38;P= 0.0012）与睾酮恢复至阉割上水平（50 ng/dL）显着相关。将患者分为3个风险组后，低风险组在雄激素剥夺治疗终止2年后睾酮恢复至正常水平的比率为100%，而高风险组为20.8%（P< 0.0001）;低风险组睾酮恢复至去势上水平的比率为100%，而高风险组为51.5%结论雄激素剥夺治疗的持续时间和达到睾酮最低值20 ng/dL均预测接受雄激素剥夺治疗的前列腺癌患者接受外照射治疗后睾酮恢复到去势水平。
ObjectivesTo determine the predictors of testosterone recovery after termination of androgen deprivation therapy in high/intermediate‐risk prostate cancer patients receiving external beam radiation therapy with neoadjuvant and adjuvant androgen deprivation therapy.MethodsA total of 82 patients who underwent external beam radiation therapy with androgen deprivation therapy for prostate cancer were retrospectively analyzed. Serum testosterone levels after androgen deprivation therapy terminations were studied. Cox proportional hazard models and the Kaplan–Meier method were used for statistical analysis.ResultsMedian age, baseline testosterone, nadir testosterone and duration of androgen deprivation therapy were 73 years, 456 ng/dL, 16 ng/dL and 26 months, respectively. Androgen deprivation therapy duration of 33 months (hazard ratio 0.13;P= 0.0018), nadir testosterone of 20 ng/dL (hazard ratio 0.35;P= 0.0112) and testosterone >50 ng/dL at 6 months after androgen deprivation therapy termination (hazard ratio 0.21;P= 0.0075) were significantly associated with testosterone recovery to normal levels (200 ng/dL) on multivariate analysis. Androgen deprivation therapy duration of 33 months (hazard ratio 0.31;P= 0.0023) and nadir testosterone of 20 ng/dL (hazard ratio 0.38;P= 0.0012) were significantly associated with testosterone recovery to the supracastrate level (50 ng/dL) on multivariate analysis. After dividing patients into three risk groups, the rate of testosterone recovery to the normal level after 2 years of androgen deprivation therapy termination was 100% in the low‐risk group versus 20.8% in the high‐risk group (P< 0.0001); the rate of testosterone recovery to the supracastrate level was 100% in the low‐risk group versus 51.5% in the high‐risk group (P< 0.0001).ConclusionsDuration of androgen deprivation therapy and achievement of nadir testosterone 20 ng/dL both predict testosterone recovery to the supracastrate level in prostate cancer patients undergoing external beam radiation therapy with androgen deprivation therapy.