雄激素剥夺和放射治疗后，睾酮恢复时间延长对前列腺癌结局有利。
Longer time to testosterone recovery impacts favorably on outcomes for prostate cancer following androgen deprivation and radiotherapy.
机构信息
Dept. of Radiation Oncology, Complejo Hospitalario Universitario de Albacete (CHUA), C/ Hnos Falcó 37, 02006, Albacete, Spain.
Laboratorio de Oncología. Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Universidad de Castilla-La Mancha, Albacete, Spain.
出版信息
Strahlenther Onkol. 2024 Aug;200(8):691-697. doi: 10.1007/s00066-024-02208-8. Epub 2024 Feb 28.
PURPOSE
To evaluate the impact of sustained hypogonadism after androgen deprivation therapy (ADT) associated with radiotherapy in prostate cancer (PCa) patients with biochemical relapse-free survival (bRFS).
METHODS
A retrospective cohort analysis of 213 consecutive PCa patients referred for radiotherapy plus ADT was carried out. Follow-up times including time to testosterone recovery (TTR) and bRFS were calculated from the end of ADT. Univariate and multivariate Cox regression analyses predicting bRFS were used. The optimal cutoffs for TTR and duration of ADT were determined using the maximally selected rank statistics (MSRS).
RESULTS
After a median follow-up of 104 months, 18 patients relapsed among those who had recovered testosterone levels and 9 among those who did not. Median ADT duration was 36 months. The optimal cutoff for TTR was determined using MSRS. TTR >48 months was significantly associated with better bRFS (logrank, p < 0.0027). Five-year bRFS was 100% for >48 months vs. 85% for <48 months. TTR was the only significant variable for bRFS in multivariate Cox analysis.
CONCLUSION
Our data show an association between longer TTR and bRFS values among PCa patients treated with ADT.
目的
评估雄激素剥夺治疗（ADT）联合放疗后持续性性腺功能减退对前列腺癌（PCa）患者生化无复发生存（bRFS）的影响。
方法
对 213 例连续接受放疗加 ADT 的 PCa 患者进行回顾性队列分析。从 ADT 结束时开始计算随访时间，包括睾酮恢复时间（TTR）和 bRFS。使用单变量和多变量 Cox 回归分析预测 bRFS。使用最大选择秩统计（MSRS）确定 TTR 和 ADT 持续时间的最佳截止值。
结果
中位随访 104 个月后，在恢复睾酮水平的患者中有 18 例复发，在未恢复睾酮水平的患者中有 9 例复发。ADT 持续时间中位数为 36 个月。使用 MSRS 确定了 TTR 的最佳截止值。TTR >48 个月与更好的 bRFS 显著相关（logrank，p < 0.0027）。5 年 bRFS 为 >48 个月者为 100%，<48 个月者为 85%。TTR 是多变量 Cox 分析中唯一与 bRFS 显著相关的变量。
结论
我们的数据表明，接受 ADT 治疗的 PCa 患者的 TTR 与 bRFS 值之间存在关联。
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