Pretreatment Serum Testosterone and Androgen Deprivation: Effect on Disease Recurrence and Overall Survival in Prostate Cancer Patients Treated With Brachytherapy
| Autor: | Al V. Taira, K.E. Wallner, Edward Adamovich, Zachariah A. Allen, Wayne M. Butler, Gregory S. Merrick, Jonathan H. Lief, Robert W. Galbreath |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Colorectal cancer medicine.drug_class medicine.medical_treatment Brachytherapy Urology Rectum Disease-Free Survival Androgen deprivation therapy Prostate cancer Reference Values Prostate Biomarkers Tumor medicine Humans Testosterone Radiology Nuclear Medicine and imaging Aged Analysis of Variance Radiation business.industry Prostatic Neoplasms Androgen Antagonists Middle Aged medicine.disease Androgen Surgery medicine.anatomical_structure Oncology Neoplasm Recurrence Local business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 74:1143-1149 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2008.09.046 |
| Popis: | Results: The median maximum, mean, and minimum doses delivered to the colon or rectum affected by the sCRC were 39.3 (range, 0.2-66.0), 5.4 (range, 0.2-41.3) and 0.6 (range, 0.2-7.8) Gy, respectively. The estimated rectal doses after prostate RT were significantly higher (p\0.001) than those delivered to non-rectal colic structures, but only 1 (9%) patient presented a rectal cancer. The differential mean dose administered to the rectosigmoid junction and sigmoid colon, with or without sCRC, were not significantly different (p = 0.2 and p = 0.3, respectively). Results: Six year bPFS, cause-specific survival (CSS) and overall survival (OS) were 98.3%, 99.8%, and 90.7%, respectively. Comparing patients with low or low normal testosterone to those with average or higher testosterone, there was no significant dif- ference in bPFS (97.9% vs. 98.4%, p = 0.71), CSS (99.7% vs. 100%, p = 0.95) or OS (90.6% vs. 90.6%, p = 0.95). Among patients with average and higher pretreatment testosterone, there was no significant difference in outcomes comparing patients who did and did not receive androgen deprivation therapy (ADT). For patients with low or low normal testosterone levels, there was no signif- icant difference in bPFS or CSS comparing patient who did or did not receive ADT. However, overall survival was significantly decreased in patients with baseline lower testosterone levels who also received ADT (83.5% vs. 94.3%, p = 0.002). Overall, 43 patients have died with only 1 patient dead of metastatic prostate cancer. In patients with average and higher pretreatment testos- teronelevels,15patientshavediedwith3(20%)attributedtocardiovasculardisease.Incontrast,inpatientswithloworlownormal testosterone, 14 of the 28 (50%) deaths have been related to cardiovascular disease. Conclusions: Low pretreatment testosterone levels alone did not impact disease recurrence or overall survival. However, patients with baseline low testosterone who also received ADT experienced a decrease in overall survival. |
| Databáze: | OpenAIRE |
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