Testosterone Recovery Profiles After Short-Term ADT

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Testosterone (T) Recovery Profiles After Short-Term Androgen Deprivation Therapy (ADT) (2022)
JFlores Martinez, BNascimento, NBenfante, ESchofield, JPMulhall


Introduction

ADT plays a major role in several scenarios for men with prostate cancer. T recovery after ADT cessation may be incomplete with 10% of men estimated to suffer persistent castrate levels after long-term ADT.



Objective

The objective of this study was to evaluate T recovery after short courses of ADT.


Methods

The study population included men treated with ≤6 months of ADT in association with radiation therapy (RT). Early morning T levels were collected at baseline and periodically after ADT cessation. T recovery after ADT cessation was analyzed in 2 ways: improvement to non-castrated level (T ≥50 ng/dL), and recovery to normal (T ≥ 300 ng/dL). Recovery rates and median survival time were estimated using Kaplan-Meier statistics and predictors were analyzed using Cox proportional hazard ratios.


Results

88 men with a mean age of 68 ± 8 years at the time of ADT were analyzed. The median duration of ADT was 3.1 months; 56% had an ADT duration between 1-3 months and 44% between 4-6 months. The mean pre-ADT T level was 390 ± 158 ng/dL. After cessation of ADT, the median time to non- castrate levels was 9.3 (IQR = 6.3 – 18.5) months and 15.8 (IQR = 8.3 - 33.8) `months for recovery to T ≥300 ng/dL. Higher baseline T levels (T > 400 ng/dL) were associated with faster recovery to normal T level (HR = 1.80, 95% CI = 1.09 – 2.95), but not to non-castrated level. Neither age > 65 years, prevalent diabetes, nor ADT duration of 4-6 months vs ≤ 3 months were significantly associated with a slower T recovery.


Conclusions

Most of our patients remained with low T levels one year after the cessation of ADT. Higher baseline T was associated with faster T recovery to normal (T ≥ 300 ng/dL).
 
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