Baseline serum testosterone in men treated with androgen deprivation therapy and radiotherapy for localized prostate cancer

MacK Roach, Kyounghwa Bae, Colleen Lawton, B. J. Donnelly, David Grignon, Gerald E. Hanks, Arthur Porter, Herbert Lepor, Varagur Venketesan, Howard Sandler

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Introduction: It is believed that men diagnosed with prostate cancer and a low baseline serum testosterone (BST) may have more aggressive disease, and it is frequently recommended they forgo testosterone replacement therapy. We used two large Phase III trials involving androgen deprivation therapy and external beam radiation therapy to assess the significance of a BST. Methods and Materials: All patients with a BST and complete data (n = 2,478) were included in this analysis and divided into four categories: "Very Low BST" (VLBST) ≤16.5th percentile of BST (≤248 ng/dL; n = 408); "Low BST" (LBST) >16.5th percentile and ≤33rd percentile (>248 ng/dL but ≤314 ng/dL; n = 415); "Average BST" (ABST) >33rd percentile and ≤67th percentile (314-437 ng/dL; n = 845); and "High BST" (HBST) >67th percentile (>437 ng/dL; n = 810). Outcomes included overall survival, distant metastasis, biochemical failure, and cause-specific survival. All outcomes were adjusted for the following covariates: treatment arm, BST, age (<70 vs. ≥70), prostate-specific antigen (PSA; <10 vs. 10 ≤ PSA <20 vs. 20 ≤), Gleason score (2-6 vs. 7 vs. 8-10); T stage (T1-T2 vs. T3-T4), and Karnofsky Performance Status (60-90 vs. 100). Results: On multivariable analysis age, Gleason score, and PSA were independently associated with an increased risk of biochemical failure, distant metastasis and a reduced cause-specific and overall survival (p < 0.05), but BST was not. Conclusions: BST does not affect outcomes in men treated with external beam radiation therapy and androgen deprivation therapy for prostate cancer.

Original languageEnglish (US)
Pages (from-to)1314-1322
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume78
Issue number5
DOIs
StatePublished - Dec 1 2010

Keywords

  • Androgen deprivation therapy
  • Clinical trials
  • Prognostic factors
  • Prostate cancer
  • Radiation therapy
  • Serum testosterone

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

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    Roach, M., Bae, K., Lawton, C., Donnelly, B. J., Grignon, D., Hanks, G. E., Porter, A., Lepor, H., Venketesan, V., & Sandler, H. (2010). Baseline serum testosterone in men treated with androgen deprivation therapy and radiotherapy for localized prostate cancer. International Journal of Radiation Oncology Biology Physics, 78(5), 1314-1322. https://doi.org/10.1016/j.ijrobp.2009.09.073