Recovery of serum testosterone after neoadjuvant androgen deprivation therapy and radical radiotherapy in localized prostate cancer

Abstract

before treatment (baseline), during LHRHa treatment, and at 6, 12, 18, 24 and > 40 weeks after the last LHRHa injection. RESULTSThe median (range) time from the first to last LHRHa injection was 116 (54-194) days. The mean (95% confidence interval) testosterone levels (in nmol/L) at baseline, during treatment and at 6, 12, 18, 24 and > 40 weeks afterward were 12.0 (10.8-13.1), 0.6 (0.5-0.7), 1.4 (0.6-2.2), 11.4 (9.7-13), 12.2 (10.5-14), 10.4 (8.9-12) and 11.7 (10.5-13). Four men had low baseline testosterone levels ( < 6.1 nmol/L). At 6 weeks after the last LHRHa injection, no men had testosterone levels in the 'normal' range; 35% were in the normal range at 12 weeks, 85% at 18 weeks, 89% at 24 weeks, and 96% at 1 year. CONCLUSIONAfter LHRHa treatment and radiotherapy, the testosterone levels of most men had recovered to normal by 18-24 weeks after the last LHRHa injection.

Kinetics of testosterone recovery in clinically localized prostate cancer patients treated with radical prostatectomy and subsequent short-term adjuvant androgen deprivation therapy

“…In a randomized clinical trial using intermittent hormonal therapy for PCa patients with increasing PSA after definitive local treatment, Gulley et al 6 found that after 6 months of ADT, more than 90% patients achieved supracastrate serum testosterone level by 18 weeks. In another study Murthy and colleagues 8 found that after short-course (lasted 54-194 days) neoadjuvant ADT and radical radiotherapy in localized PCa, all patients recovered to supracastrate testosterone level by 12 weeks after the last LHRH agonists injection. Results from the present study showed that 97.9% and 100% patients could recover to supracastrate testosterone level at 3 and 6 months after cessation of 9-month ADT.…”

“…[3][4][5][6][7][8][9] It has been reported that if a patient had baseline testosterone level below the normal range, it is difficult for him to recover to normal range after the cessation of ADT. 4 The first strength of the present study is that we defined a serum testosterone level o230 ng dl 21 as normal and excluded patients whose baseline testosterone lower than normal level.…”

“…15,16 Previously, Gulley et al 6 defined testosterone o212 ng dl 21 as normal and found that 80% patients achieved this level at 6 months after short-term (6 months) ADT. 6 In another study Murthy et al 8 defined testosterone o6 nmol l 21 (173 ng dl 21 ) as normal and reported that after short-term (54-194 days) neoadjuvant ADT and EBRT, 89% patients recovered to normal range at 6 months. However, in this study, only 66.3% patients recovered to normal testosterone level at 6 months after the cessation of short-term (9 months) adjuvant ADT.…”

“…Most previous studies which investigated testosterone recovery included patients treated by ADT combined with EBRT and did not set a control group receiving EBRT alone. [3][4][5][6][7][8][9] Therefore, they could not separate the effects of ADT on the extent and timing of testosterone recovery from that of EBRT plus ADT. [3][4][5][6][7][8][9] Benefit from the design of this study, testosterone recovery in our patients bears only the effect of 9-month adjuvant ADT.…”

“…Most previous studies investigating this issue are retrospectively designed and have some limitations, including (i) devoid of measuring baseline testosterone level before ADT; (ii) inconsistency of ADT duration in the same study; and (iii) lack of considering the effect of radiation therapy on testosterone recovery. [3][4][5][6][7][8][9][10] Therefore, the results from previous studies are controversial and confusing.…”