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Unrecognized kinetics of serum testosterone: Impact on short-term androgen deprivation therapy for prostate cancer

 Kyo Chul Koo  ;  Dong Hoon Lee  ;  Kyu Hyun Kim  ;  Seung Hwan Lee  ;  Chang Hee Hong  ;  Sung Joon Hong  ;  Byung Ha Chung 
 YONSEI MEDICAL JOURNAL, Vol.55(3) : 570-575, 2014 
Journal Title
Issue Date
Adult ; Androgen Antagonists/therapeutic use* ; Follicle Stimulating Hormone/blood ; Humans ; Luteinizing Hormone/blood ; Male ; Middle Aged ; Prospective Studies ; Prostatic Neoplasms/blood* ; Prostatic Neoplasms/drug therapy* ; Testosterone/blood* ; Treatment Outcome ; Young Adult
Androgens ; kinetics ; testosterone
PURPOSE: To evaluate the kinetics of serum testosterone (T) recovery following short-term androgen deprivation therapy (ADT), as the understanding thereof is essential for the proper management of prostate cancer (PCa), especially intermittent ADT. MATERIALS AND METHODS: This prospective analysis included male sex offenders who voluntarily received leuprolide acetate in order to alleviate sexual aberrance. Thirty-three and 25 patients who received 3 and 6 months of ADT were assigned to Group A and Group B, respectively. Serum T levels were obtained every week during the on-cycle period, then monthly during the off-cycle period for at least 12 months. RESULTS: The kinetics of serum T during the on-cycle period were similar in both groups. After flare reaction at week 2, a nadir of 0.45±0.29 ng/mL was achieved. In Group A, an abrupt rebound-upsurge was observed during the first 2 month off-cycle period, which surpassed the baseline level and reached a plateau level of 8.74±2.11 ng/mL during the flare (p<0.001). This upsurge was followed by a gradual decline back to baseline over the following 10 months. In Group B, a gradual increase was observed, and a baseline level of 7.26±1.73 ng/mL was reached at 5 months. Thereafter, an ongoing upsurge that surpassed baseline levels was observed until 12 months (8.81±1.92 ng/mL; p=0.002). CONCLUSION: The kinetics of serum T recovery during the off-cycle period varied according to the duration of ADT. Serum T should be monitored beyond normalization, as an excessive rebound may improve quality-of-life, but hamper the treatment efficacy of PCa.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Lee, Dong Hoon(이동훈)
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
Hong, Chang Hee(홍창희) ORCID logo https://orcid.org/0000-0002-0946-7702
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