External beam radiation therapy (EBRT) with short-term androgen deprivation therapy is the standard of care for intermediate-risk prostate cancer patients. However, no study to date has evaluated the hormonal kinetics or sexual and hormonal function recovery after cessation of short-term luteinizing hormone (LH)-releasing hormone (LHRH) antagonist treatment.
Ten intermediate-risk prostate cancer patients (mean age, 69.9 years) were included. All patients received 4 months of LHRH antagonist (degarelix) treatment followed by EBRT. The testosterone, luteinizing hormone (LH), follicle-stimulating hormone, and prostate-specific antigen levels were measured and Expanded Prostate Cancer Index Composite questionnaires were completed before LHRH antagonist therapy at baseline; 1, 2, 3, and 4 months after the first injection of LHRH antagonist treatment; and every 2 months thereafter until 18 months.
The testosterone levels were at the castration level at 1 month after the first LHRH antagonist injection. The median interval to recover a normal testosterone level (> 7.2 nmol/L) was 7 months after the last LHRH antagonist administration. The LH and follicle-stimulating hormone levels decreased but had increased more than twice above baseline at 15 months after the last LHRH antagonist injection. The sexual function and hormonal bother subdomain scores and sexual and hormonal domain scores decreased once after LHRH antagonist treatment but had significantly recovered thereafter (P < .05).
In most patients, the testosterone level had normalized within 9 months after the last LHRH administration. Sexual and hormonal function recovered after short-term LHRH antagonist administration for neoadjuvant therapy before EBRT.
Clinical genitourinary cancer. 2017 Sep 23 [Epub ahead of print]
Takahiro Inoue, Takashi Mizowaki, Daijiro Kabata, Ayumi Shintani, Naoki Terada, Toshinari Yamasaki, Hiromitsu Negoro, Takashi Kobayashi, Kiyonao Nakamura, Haruo Inokuchi, Osamu Ogawa
Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: ., Department of Radiation Oncology and Imaged-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan., Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan., Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.