Testosterone Recovery Profiles After Short-Term ADT

madman

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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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Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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