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A nomogram for testosterone recovery following combined androgen deprivation therapy and radiation therapy for prostate cancer.

Publication ,  Conference
Spiegel, D; Hong, JC; Lee, WR; Salama, JK
Published in: Journal of Clinical Oncology
February 20, 2017

67 Background: Combined androgen deprivation therapy (ADT) and radiation therapy (RT) is a frequently used localized prostate cancer (PC) treatment. Testosterone recovery (TR) after combined ADT-RT is not well-characterized. We studied TR in men who received RT and either short-term (ST) ADT or long-term (LT) ADT with LHRH agonists. Methods: We identified consecutive localized PC patients treated with ADT-RT at the Durham VA Medical Center (DVAMC) from 1/2011-10/2016. All patients had a documented baseline testosterone (T) level. Individual patient records were reviewed. TR was defined as time from last ADT injection to T normalization ( > 240 ng/dL). The Kaplan-Meier method was used to estimate time to TR. Cox proportional hazards models were generated to identify TR predictors with a nomogram built based on a parsimonious multivariate model. Results: 252 patients were identified. Median follow-up was 26.7 months. Median age was 65. Prior to treatment, 69% had a normal baseline T. 67% were treated with STADT, median duration 6 months. 33% were treated with LTADT, median duration 18 months. Median time for TR was 22.6 months for all patients (19.5 months for STADT and 25.6 months for LTADT). At 1 and 2 years post ADT, estimated TR was 13% and 53% (17% and 57% for STADT and 3% and 42% for LTADT). 2-year biochemical control was 99.2% and 97.6% for STADT and LTADT, respectively; 98.9% and 98.6% for those with and without TR, respectively. On multivariate analysis, higher pre-treatment T (HR = 1.004 95% CI 1.003-1.006, p < 0.001), use of STADT (HR = 2.48 95% CI 1.45-4.25, p = 0.001), and lower BMI (HR = 0.95 95% CI 0.91-0.98, p = 0.001) were associated with shorter time to TR. White race was a negative TR predictor (HR = 0.65 95% CI 0.43-0.9992, p = 0.049). Age, smoking, and Charlson Comorbidity Index were not significant independent TR predictors. A nomogram was generated to predict probability of TR at 1, 2, and 3 years. Conclusions: In this VA population of localized PC patients treated from 2011-2016, TR following the use of ADT-RT was variable. Using pre-treatment T levels, ADT duration, BMI, and race, a predictive nomogram can estimate the likelihood of TR.

Duke Scholars

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

February 20, 2017

Volume

35

Issue

6_suppl

Start / End Page

67 / 67

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Spiegel, D., Hong, J. C., Lee, W. R., & Salama, J. K. (2017). A nomogram for testosterone recovery following combined androgen deprivation therapy and radiation therapy for prostate cancer. In Journal of Clinical Oncology (Vol. 35, pp. 67–67). American Society of Clinical Oncology (ASCO). https://doi.org/10.1200/jco.2017.35.6_suppl.67
Spiegel, Daphna, Julian C. Hong, W Robert Lee, and Joseph Kamel Salama. “A nomogram for testosterone recovery following combined androgen deprivation therapy and radiation therapy for prostate cancer.” In Journal of Clinical Oncology, 35:67–67. American Society of Clinical Oncology (ASCO), 2017. https://doi.org/10.1200/jco.2017.35.6_suppl.67.
Spiegel D, Hong JC, Lee WR, Salama JK. A nomogram for testosterone recovery following combined androgen deprivation therapy and radiation therapy for prostate cancer. In: Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2017. p. 67–67.
Spiegel, Daphna, et al. “A nomogram for testosterone recovery following combined androgen deprivation therapy and radiation therapy for prostate cancer.Journal of Clinical Oncology, vol. 35, no. 6_suppl, American Society of Clinical Oncology (ASCO), 2017, pp. 67–67. Crossref, doi:10.1200/jco.2017.35.6_suppl.67.
Spiegel D, Hong JC, Lee WR, Salama JK. A nomogram for testosterone recovery following combined androgen deprivation therapy and radiation therapy for prostate cancer. Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2017. p. 67–67.

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

February 20, 2017

Volume

35

Issue

6_suppl

Start / End Page

67 / 67

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences