Prognostic value of testosterone castration levels following androgen deprivation and high-dose radiotherapy in localized prostate cancer: Results from a phase III trial

Zapatero, A.; Alvarez, A.; Guerrero, A.; Maldonado, X.; Segundo, Carmen González San; Cabeza, M.A.; Vidales, C. Martín de; Solé, Josep María Macias i; Olivé, A. Pedro; Casas, Francesc; Boladeras, A.; Torre, M. L. Vázquez de la; Vara, Susana

doi:10.1016/j.radonc.2021.04.018

Cited by 9 publications

(3 citation statements)

References 28 publications

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“…The use of testosterone treatment in patients with previous prostate cancer is highly debated as testosterone has been suggested to increase prostate cancer risk and disease progression (Morgentaler & Traish 2009). In contrast, a short time to recovery of endogenous serum testosterone is not considered a risk factor for relapse (Roy et al 2020, Zapatero et al 2021. Randomized controlled trials of testosterone treatment for the recovery of serum testosterone levels are missing.…”

Section: Discussionmentioning

confidence: 99%

Pituitary-testis axis dysfunction following adjuvant androgen deprivation therapy

Abildgaard

Stroomberg

Bang

et al. 2023

Endocrine-Related Cancer

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Men with high-risk, non-metastatic prostate cancer receive adjuvant androgen deprivation therapy (ADT) for at least 2 years according to Danish guidelines. It remains unclarified if patients regain function of the pituitary-testis axis after cessation of ADT. Thus, we aimed to investigate the function of the pituitary-testis axis following adjuvant ADT. In this study, we included men who underwent external beam radiation therapy and ADT for high-risk prostate cancer. All patients underwent assessment of testosterone deficiency (TD) symptoms, full biochemical assessment of the pituitary-testis axis, and dynamic stimulatory tests of gonadotropin (GnRH test) and testosterone production (HCG test). Patients were diagnosed with TD based on a combination of TD symptoms and testosterone below age specific reference ranges. TD was characterized as primary, secondary, or mixed based on serum gonadotropins and stimulatory tests. We found, that among the 51 patients included in the study, the median time on ADT was 3.2 years and median time since ADT cessation was 3.8 years. Twenty-eight patients were diagnosed with TD; 10 had primary TD (testicular dysfunction), 11 secondary TD (pituitary dysfunction), and 7 mixed TD (combined pituitary and testicular dysfunction). An inadequate testosterone response to hCG stimulation was shown in 42 patients, whereas only 11 patients had a subnormal gonadotropin response to GnRH. We conclude that persistent TD is a common long-term consequence of adjuvant ADT in prostate cancer survivors, equally distributed between pituitary and testicular dysfunction. The study emphasizes the necessity for systematic follow-up of full pituitary-testis axis function in patients receiving adjuvant ADT.

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Section: Discussionmentioning

confidence: 99%

Pituitary-testis axis dysfunction following adjuvant androgen deprivation therapy

Abildgaard

Stroomberg

Bang

et al. 2023

Endocrine-Related Cancer

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“…The number of elderly men will substantially increase in the coming decades and hence their well-being is of general concern for public health [49]. Moreover, testosterone levels may also play an important role in the development of prostate cancer [53], and they have potential implications for the prognosis of prostate cancer patients [54].…”

Section: Discussionmentioning

confidence: 99%

Dietary Acid Load Is Not Associated with Serum Testosterone in Men: Insights from the NHANES

Storz

Ronco

2023

Nutrients

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The dietary acid load (DAL) is a novel marker of overall diet quality, which has been associated with overweight, type 2 diabetes and altered glucocorticoid secretion. A potential association with sex hormones is thus not inconceivable. We investigated whether DAL was associated with serum total testosterone concentrations of men in the National Health and Nutrition Examination Survey. The DAL scores, including the potential renal acid load (PRAL) and net endogenous acid production (NEAP), were estimated and compared between participants with low and normal testosterone levels. The investigated sample encompassed n = 377 males with a mean age of 49.50 years. Approximately 73% of the sample were of Non-Hispanic White origin. None of the examined DAL scores showed significant associations with serum testosterone levels. We observed no significant differences in the crude DAL scores between individuals with low testosterone levels and individuals with normal testosterone levels. Multivariate regression models adjusting for covariates confirmed the lack of associations between the PRAL and serum testosterone. Our results are of particular importance for those individuals who wish to lower their DAL in light of the presumable health effects of a more alkaline diet. Our data suggest that diet modifications toward a lower intake of animal protein and refined grains (which consecutively translates into a lower DAL) may not negatively affect men’s testosterone levels.

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“…On the other hand, our study included patients who received BT boosts using a fraction dose of approximately 10 Gy. Giving that, the probability of PSA bounces increases with fraction dose [ 23 ] and perhaps this index could prove to be useful in patients receiving a single-fraction BT boost with a higher fraction dose. PSA bounce is challenged by a few important limitations related to definition of the index.…”

Section: Discussionmentioning

confidence: 99%

Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer

Miszczyk¹,

Magrowski²,

Masri³

et al. 2022

jcb

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Purpose Serum prostate-specific antigen (PSA) kinetics has been linked to prognosis in prostate cancer (PCa) patients. Our goal was to analyze the association between PSA kinetics and metastasis-free survival (MFS) in patients with localized PCa treated with high-dose-rate (HDR) brachytherapy (BT) boost combined with external beam radiotherapy (EBRT). Material and methods We retrospectively analyzed multiple PSA kinetics related to PSA nadir (nPSA), PSA bouncing, and biochemical recurrence (BCR) in 186 PCa patients treated with neoadjuvant androgen deprivation therapy (ADT), followed by EBRT combined with HDR-BT boost. Uni- and multivariate Cox regression models were calculated to assess the value of PSA-related parameters for the prediction of MFS. Results 5- and 10-year MFS were 95% and 84%, respectively. Median nPSA was 0.011 (IQR, 0.007-0.057) ng/ml and predicted MFS in multivariable analysis. Implementation of nPSA improved c-index of baseline model from 0.8 to 0.68. nPSA of 0.2 ng/ml offered the most optimal discriminatory ability for identifying patients with better prognoses. Time to nPSA (median, 11 months; IQR, 8-18 months) and PSA bounce, which occurred in 12.4% of patients, were not significantly associated with MFS. Conclusions Lower values of nPSA are significantly associated with decreased risk of developing metastases in patients treated with EBRT combined with HDR-BT boost and ADT, and improve the accuracy of a clinical model for MFS.

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Prognostic value of testosterone castration levels following androgen deprivation and high-dose radiotherapy in localized prostate cancer: Results from a phase III trial

Cited by 9 publications

References 28 publications

Pituitary-testis axis dysfunction following adjuvant androgen deprivation therapy

Pituitary-testis axis dysfunction following adjuvant androgen deprivation therapy

Dietary Acid Load Is Not Associated with Serum Testosterone in Men: Insights from the NHANES

Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer

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