Bong Gary W, Clarke Harry S, Hancock Wanda C, Keane Thomas E
Department of Urology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Urology. 2008 Jun;71(6):1177-80. doi: 10.1016/j.urology.2007.09.066. Epub 2008 Feb 15.
The time to testosterone recovery after the cessation of androgen deprivation therapy appears to be dependent on the therapy duration. Most men will recover normal testosterone levels within 18 months according to the findings from studies that frequently involved fewer than 3 years of androgen deprivation therapy. Our goal was to assess the proportion of patients who remain castrated after cessation of longer duration luteinizing hormone-releasing hormone (LHRH) agonist therapy for prostate cancer.
We reviewed 15 patients who had received at least 48 months of continuous goserelin injection therapy for prostate cancer and had not been receiving the therapy for at least 18 months. The serum testosterone and prostate-specific antigen data were obtained.
The mean duration of LHRH agonist therapy was 73 months (range 48 to 110). At the cessation of therapy after a mean follow-up of 31 months, 53% had testosterone levels that remained castrated. Only 1 patient achieved normal testosterone levels. Of the patients with greater than castrate testosterone levels, 71% experienced a prostate-specific antigen rise. All the men with an intact prostate who had testosterone recovery to greater than castrate levels had a prostate-specific antigen increase, which might represent a return toward the pretreatment baseline. Of the patients who started therapy after age 70 years, 78% remained castrated versus 17% of those who started before 70 years.
Of the men who had received 4 or more years of LHRH agonist therapy for prostate cancer, 53% remained castrated up to 2.5 years after therapy cessation. Patients who started LHRH agonist therapy after age 70 were more likely to remain castrate after stopping long-term therapy.
雄激素剥夺治疗停止后睾酮恢复的时间似乎取决于治疗持续时间。根据那些通常涉及不到3年雄激素剥夺治疗的研究结果，大多数男性会在18个月内恢复正常睾酮水平。我们的目标是评估在停止较长时间的促黄体生成素释放激素（LHRH）激动剂治疗前列腺癌后仍处于去势状态的患者比例。
我们回顾了15例接受至少48个月戈舍瑞林连续注射治疗前列腺癌且至少18个月未接受该治疗的患者。获取血清睾酮和前列腺特异性抗原数据。
LHRH激动剂治疗的平均持续时间为73个月（范围48至110个月）。在平均随访31个月后停止治疗时，53%的患者睾酮水平仍处于去势状态。只有1例患者达到正常睾酮水平。在睾酮水平高于去势水平的患者中，71%经历了前列腺特异性抗原升高。所有前列腺完整且睾酮恢复至高于去势水平的男性都出现了前列腺特异性抗原升高，这可能代表恢复到治疗前基线水平。在70岁以后开始治疗的患者中，78%仍处于去势状态，而70岁以前开始治疗的患者这一比例为17%。
在接受4年或更长时间LHRH激动剂治疗前列腺癌的男性中，53%在治疗停止后长达2.5年仍处于去势状态。70岁以后开始LHRH激动剂治疗的患者在停止长期治疗后更有可能保持去势状态。
