Western Radiation Oncology, Mountain View, CA, USA.
Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):e33-8. doi: 10.1016/j.ijrobp.2011.01.027. Epub 2011 Apr 7.
To evaluate temporal changes in testosterone after prostate brachytherapy and investigate the potential impact of these changes on response to treatment.
Between January 2008 and March 2009, 221 consecutive patients underwent Pd-103 brachytherapy without androgen deprivation for clinically localized prostate cancer. Prebrachytherapy prostate-specific antigen (PSA) and serum testosterone were obtained for each patient. Repeat levels were obtained 3 months after brachytherapy and at least every 6 months thereafter. Multiple clinical, treatment, and dosimetric parameters were evaluated to determine an association with temporal testosterone changes. In addition, analysis was conducted to determine if there was an association between testosterone changes and treatment outcomes or the occurrence of a PSA spike.
There was no significant difference in serum testosterone over time after implant (p = 0.57). 29% of men experienced an increase ≥ 25%, 23% of men experienced a decrease ≥ 25%, and the remaining 48% of men had no notable change in testosterone over time. There was no difference in testosterone trends between men who received external beam radiotherapy and those who did not (p = 0.12). On multivariate analysis, preimplant testosterone was the only variable that consistently predicted for changes in testosterone over time. Men with higher than average testosterone tended to experience drop in testosterone (p < 0.001), whereas men with average or below average baseline testosterone had no significant change. There was no association between men who experienced PSA spike and testosterone temporal trends (p = 0.50) nor between initial PSA response and testosterone trends (p = 0.21).
Prostate brachytherapy does not appear to impact serum testosterone over time. Changes in serum testosterone do not appear to be associated with PSA spike phenomena nor with initial PSA response to treatment; therefore, PSA response does not seem related to temporal testosterone changes.
评估前列腺近距离放射治疗后睾酮的时间变化，并探讨这些变化对治疗反应的潜在影响。
2008 年 1 月至 2009 年 3 月，221 例临床局限性前列腺癌患者行 Pd-103 近距离放射治疗，未行雄激素剥夺治疗。每位患者均在近距离放射治疗前获得前列腺特异性抗原（PSA）和血清睾酮水平。在近距离放射治疗后 3 个月及此后至少每 6 个月重复检测这些水平。评估多个临床、治疗和剂量学参数，以确定与睾酮时间变化的相关性。此外，还进行了分析，以确定睾酮变化与治疗结果或 PSA 飙升之间是否存在关联。
植入后血清睾酮随时间无显著差异（p = 0.57）。29%的男性睾酮水平升高≥25%，23%的男性睾酮水平下降≥25%，其余 48%的男性睾酮水平随时间无明显变化。接受外照射放疗和未接受外照射放疗的男性睾酮趋势无差异（p = 0.12）。多变量分析显示，植入前睾酮是唯一能持续预测睾酮随时间变化的变量。睾酮水平较高的男性倾向于出现睾酮下降（p < 0.001），而基线睾酮水平中等或较低的男性则无明显变化。经历 PSA 飙升的男性与睾酮时间趋势之间无关联（p = 0.50），也与初始 PSA 反应与睾酮趋势之间无关联（p = 0.21）。
前列腺近距离放射治疗似乎不会随时间影响血清睾酮水平。血清睾酮变化似乎与 PSA 飙升现象或初始 PSA 对治疗的反应无关；因此，PSA 反应似乎与睾酮时间变化无关。
