Mp05-07 Prolonged Hormonal Therapy and External Beam Radiation Independently Increase the Risk of Persistent Hypogonadism in Men Treated With Prostate Brachytherapy
Year: 2017
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy I1 Apr 2017MP05-07 PROLONGED HORMONAL THERAPY AND EXTERNAL BEAM RADIATION INDEPENDENTLY INCREASE THE RISK OF PERSISTENT HYPOGONADISM IN MEN TREATED WITH PROSTATE BRACHYTHERAPY Daniel Sagalovich, Kyrollis Attalla, David Paulucci, John Sfakianos, Ketan Badani, Ashutosh Tewari, Richard Stock, and Nelson Stone Daniel SagalovichDaniel Sagalovich More articles by this author , Kyrollis AttallaKyrollis Attalla More articles by this author , David PaulucciDavid Paulucci More articles by this author , John SfakianosJohn Sfakianos More articles by this author , Ketan BadaniKetan Badani More articles by this author , Ashutosh TewariAshutosh Tewari More articles by this author , Richard StockRichard Stock More articles by this author , and Nelson StoneNelson Stone More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.166AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We sought to identify variables that may predict persistent hypogonadism and castration in patients with prostate cancer (PCa) treated with brachytherapy (BT). METHODS A retrospective analysis was performed on a prospectively maintained database of patients receiving BT ± external beam radiation therapy (EBRT) ± hormone therapy (HT) for NCCN low, intermediate or high-risk prostate cancer at a single institution between 1990-2011 with a minimum follow-up of 5 years. Patients were categorized as receiving no HT (n=438, 41.6%), ≤ 6 months (n=317, 31.1%) or > 6 months (n=298, 28.3%) of HT. Those receiving combination HT within one year of final testosterone (T) measurement were excluded, as well as patients receiving salvage ADT at any time. 5 and 10-year freedom from persistent hypogonadism (T<280 ng/dL) and castration (T<50 ng/dL) for each group was evaluated with Kaplan-Meier estimates. Multivariable cox proportional hazards models were used to compare risk of persistent hypogonadism and castration at a median follow-up of 6.5 years (post-treatment to final T) (IQR: 4.3-9.1 years; Range: 1.0-19.2 years). RESULTS Of 1,981 patients receiving BT for clinically localized PCa, 1,053 met inclusion criteria. The 5-year freedom from hypogonadism rates were 92.4%, 88.9% and 87.0% for patients with no HT, ≤ 6 months and > 6 months of HT, respectively (10-year rates: 66.7%, 55.3%, 40.5%); 5-year freedom from castration rates were 99.2%, 98.0% and 98.4%, respectively (10-year rates: 97.9%, 95.5%, 90.9%). In multivariable analyses, number of months of HT (continuous variable, HR=1.04, p=.030) and BT with EBRT vs. BT alone (HR=1.56, p=.010) significantly increased the risk of persistent hypogonadism. Older age (HR=1.04, p<.001) and diabetes (HR=1.43, p=.048) were also significant. Number of months of HT was the only variable which increased the risk of persistent castration (HR=1.09, p=.014). CONCLUSIONS EBRT is an independent risk factor for persistent hypogonadism among patients receiving BT for PCa. The mechanism of this finding needs to be elucidated, but may be secondary to scatter radiation during EBRT. Prolonged HT additionally increases the risk for persistent hypogonadism and castration. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e40 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Daniel Sagalovich More articles by this author Kyrollis Attalla More articles by this author David Paulucci More articles by this author John Sfakianos More articles by this author Ketan Badani More articles by this author Ashutosh Tewari More articles by this author Richard Stock More articles by this author Nelson Stone More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2604567136