Recovery of serum testosterone following neoadjuvant and adjuvant androgen deprivation therapy in men treated with prostate brachytherapy

• 作者: Hideyasu Tsumura Hiromichi Ishiyama Kazumasa Matsumoto Kazushige Hayakawa Kenichi Tabata Masashi Kitano Masatsugu Iwamura Shinji Kurosaka Shiro Baba Shuhei Hirano Takefumi Satoh Tetsuo Fujita
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: ANDROGEN DEPRIVATION Gonadotropinreleasing hormone agonist PROSTATE BRACHYTHERAPY PROSTATE cancer TESTOSTERONE
• 年，卷（期）: 2015,（12）
• 页码范围: 494-500
• 页数: 7页
• 分类号: R737.25

摘要

AIM: To investigate the time course of testosterone(T) recovery after cessation of androgen deprivation therapy(ADT) in patients treated with brachytherapy. METHODS: One-hundred and seventy-four patients treated between June 1999 and February 2009 were studied. Patients were divided into a short-term usage group(≤ 12 mo, n = 91) and a long-term usage group(≥ 36 mo, n = 83) according to the duration of gonadotropin-releasing hormone agonist therapy. Median follow-up was 29 mo in the short-term group and was 60 mo in the long-term group.RESULTS: Cumulative incidence rates of T recovery to normal and supracastrate levels at 24 mo after cessationwere 28.8% and 74.6%, respectively, in the long-term usage group, whereas these values were 96.4% and 98.8% in the short-term usage group. T recovery to normal and supracastrate levels occurred significantly more rapidly in the short-term than in the long-term usage group(P < 0.001 and P < 0.001, respectively). Five years after cessation, 22.6% of patients maintained a castrate T level in the long-term usage group. On multivariate analysis, lower T levels(< 10 ng/d L) at cessation of ADT was significantly associated with prolonged T recovery to supracastrate levels in the longterm usage group(P = 0.002). CONCLUSION: Lower T levels at cessation of ADT were associated with prolonged T recovery in the longterm usage group. Five years after cessation of longterm ADT, approximately one-fifth of patients still had castrate T levels. When determining the therapeutic effect, especially biochemical control, we should consider this delay in T recovery.