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- Title
Biopsy Gleason score and the duration of testosterone suppression among men treated with external beam radiation and 6 months of combined androgen blockade.
- Authors
Martin, Neil E.; Chen, Ming-Hui; Nguyen, Paul L.; Beard, Clair J.; Loffredo, Marian J.; Kantoff, Philip W.; D'Amico, Anthony V.
- Abstract
Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? The return of testosterone to normal levels following short-course androgen blockade in prostate cancer is variable. Factors associated with a longer time to recovery include older age and lower baseline testosterone level. In this study, we found that among men treated with 6 months of combined androgen blockade and radiation therapy, higher biopsy Gleason grade was associated with a shorter time to testosterone normalization. OBJECTIVE To determine whether the biopsy Gleason score is associated with duration of testosterone suppression following 6 months of combined androgen blockade (CAB) and radiation therapy (RT) in men with prostate cancer (PCa)., PATIENTS AND METHODS The study cohort consisted of 221 men with PCa treated with RT and 6 months of CAB between 1996 and 2005., We defined the duration of testosterone suppression as the time between the last day of CAB and the date the testosterone returned to ≥252 ng/dL. We used Cox regression multivariable analysis to relate biopsy Gleason score to duration of testosterone suppression following cessation of CAB., RESULTS A biopsy Gleason score of 8-10 had an adjusted hazard ratio (AHR) of 1.56 (95% confidence interval [CI] 1.04, 2.34; P= 0.03) for a shorter time to testosterone normalization relative to Gleason 6. Specifically, the 51 men with biopsy Gleason score of 8-10 had a median time to testosterone normalization of 17.0 months compared with 22.1 months and 23.8 months for those with biopsy Gleason ≤6 and 7, respectively., Increasing age was significantly associated with a longer duration of testosterone suppression (AHR of 0.95 [95% CI 0.92, 0.97; P < 0.001]) as was a higher baseline PSA (AHR 0.82 [95% CI 0.69, 0.97; P= 0.02])., CONCLUSION A biopsy Gleason score of 8-10 was associated with a shorter period of testosterone suppression following 6 months of CAB and RT. These data are consistent with the hypothesis that a factor released from high-grade PCa cells may impact on testosterone production.
- Subjects
CANCER radiotherapy; PROSTATE cancer treatment; BIOPSY; GLEASON grading system; TESTOSTERONE regulation; ANDROGENS
- Publication
BJU International, 2012, Vol 110, Issue 9, p1252
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/j.1464-410X.2012.11118.x