Planas Jacques, Celma Ana, Placer José, Cuadras Mercè, Regis Lucas, Gasanz Carlos, Trilla Enrique, Salvador Carlos, Lorente David, Morote Juan
a Urology Department , Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona , Barcelona , Spain.
Scand J Urol. 2016 Dec;50(6):425-428. doi: 10.1080/21681805.2016.1227876. Epub 2016 Sep 14.
The aim of this study was to evaluate hormonal recovery after cessation of androgen deprivation therapy (ADT) in a group of elderly prostate cancer patients.
Forty patients with locally advanced or metastatic prostate cancer, with a mean age of 71.5 years [95% confidence interval (CI) 69.1-73.9], were treated with ADT for a mean duration of 74.6 months (95% CI 59.7-89.5 months). Mean follow-up time after ADT cessation was 36.5 months (95% CI 30.6-42.3 months). Serum testosterone and luteinizing hormone (LH) were determined at 6 month intervals after ADT cessation.
After 18 months of follow-up, all patients had recovered normal LH levels, while 38% of patients still presented castration levels of testosterone (< 50 ng/dl). A multivariate analysis was performed to find factors related to testosterone recovery (testosterone >50 ng/dl). Neither age at start of ADT nor clinical stage reached statistical significance. Only time under ADT was correlated with testosterone recovery (p = .031). Kaplan-Meier curves were obtained. Mean time for testosterone recovery was 14.5 months (95% CI 6.5-22.6 months) in patients treated with ADT for less than 60 months compared to 29.3 months (95% CI 19.6-39.1 months) in patients treated with ADT for more than 60 months (log-rank p = .029).
Age did not correlate with testosterone recovery in a group of elderly prostate cancer patients in whom ADT was stopped. Testosterone recovery after ADT cessation was significantly correlated with time under ADT treatment. Significant implications related to economic aspects of the dosage schedule may be considered.
本研究旨在评估一组老年前列腺癌患者雄激素剥夺治疗（ADT）停止后激素的恢复情况。
40例局部晚期或转移性前列腺癌患者，平均年龄71.5岁[95%置信区间（CI）69.1 - 73.9]，接受ADT治疗的平均时长为74.6个月（95%CI 59.7 - 89.5个月）。ADT停止后的平均随访时间为36.5个月（95%CI 30.6 - 42.3个月）。在ADT停止后每隔6个月测定血清睾酮和促黄体生成素（LH）。
随访18个月后，所有患者的LH水平恢复正常，而38%的患者睾酮水平仍处于去势水平（<50 ng/dl）。进行多因素分析以寻找与睾酮恢复（睾酮>50 ng/dl）相关的因素。ADT开始时的年龄和临床分期均未达到统计学意义。只有ADT治疗时间与睾酮恢复相关（p = 0.031）。绘制了Kaplan - Meier曲线。接受ADT治疗少于60个月的患者，睾酮恢复的平均时间为14.5个月（95%CI 6.5 - 22.6个月），而接受ADT治疗超过60个月的患者为29.3个月（95%CI 19.6 - 39.1个月）（对数秩检验p = 0.029）。
在一组停止ADT治疗的老年前列腺癌患者中，年龄与睾酮恢复无关。ADT停止后的睾酮恢复与ADT治疗时间显著相关。可能需要考虑与给药方案经济方面相关的重要影响。
