Department of Urology, Keio University School of Medicine, Tokyo, Japan.
Int J Urol. 2023 Feb;30(2):235-239. doi: 10.1111/iju.15098. Epub 2022 Nov 14.
Due to the fear generated by COVID-19 in Spring 2020, many patients postponed their scheduled outpatient visits. To differentiate those patients with prostate cancer (PCa) whose androgen deprivation therapy (ADT) injection treatment can be postponed, we investigated the characteristics of testosterone (T) recovery in Japanese patients after they received combined ADT and radiation therapy (RT).
We included 81 patients with PCa treated with ADT and RT at Keio University Hospital from January 2013 to December 2018. T-recovery was defined as the time interval between the last ADT injection and 3-6 months after T-normalization. The Kaplan-Meier method was used to estimate time to T-recovery. Cox proportional hazards models identified T-recovery predictors.
The 50% cumulative incidence of T-recovery was 7.0 months for the 6-short-term group (defined as patients having ≤6 months of ADT therapy) versus 13.0 months for the 6-long-term group (>6 months of therapy) (p < 0.001). The incidence was 7.0 months for the 12 short-term-ADT (ST) group versus 18.0 months for the 12 long-term-ADT (LT) group (p < 0.001). Multivariate analysis revealed that a shorter duration of ADT was associated with a shorter time to T-recovery (hazard ratio, 0.253; 95% CI, 0.138-0.465; p < 0.001). No other factors were significant predictors of T-recovery.
Androgen deprivation therapy duration is significantly associated with T-recovery in Japanese patients with PCa. If a patient undergoes ADT for more than 6 or 12 months, it is possible to postpone their outpatient visits for 13 and 18 months, respectively.
由于 2020 年春季 COVID-19 引发的恐惧，许多患者推迟了预约的门诊就诊。为了区分那些可以推迟雄激素剥夺治疗（ADT）注射治疗的前列腺癌（PCa）患者，我们研究了日本患者在接受 ADT 联合放疗（RT）后睾酮（T）恢复的特征。
我们纳入了 2013 年 1 月至 2018 年 12 月期间在庆应义塾大学医院接受 ADT 和 RT 治疗的 81 例 PCa 患者。T 恢复定义为最后一次 ADT 注射后至 T 正常化后 3-6 个月的时间间隔。采用 Kaplan-Meier 法估计 T 恢复时间。Cox 比例风险模型确定 T 恢复的预测因素。
6 个短期 ADT 组（定义为 ADT 治疗时间≤6 个月）和 6 个长期 ADT 组（>6 个月）的 T 恢复累积发生率分别为 50%（7.0 个月）和 50%（13.0 个月）（p<0.001）。12 个短期 ADT（ST）组和 12 个长期 ADT（LT）组的发生率分别为 7.0 个月和 18.0 个月（p<0.001）。多变量分析显示，ADT 持续时间较短与 T 恢复时间较短相关（风险比，0.253；95%CI，0.138-0.465；p<0.001）。其他因素均不是 T 恢复的显著预测因素。
ADT 持续时间与日本 PCa 患者的 T 恢复显著相关。如果患者接受 ADT 治疗超过 6 或 12 个月，则分别有可能将其门诊就诊推迟 13 和 18 个月。
