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  • br patient is also at risk for

    2019-10-15

    
    patient is also at risk for nonrecovery of testosterone and should be counseled as such ahead of time.
    Limitations of this study include its retrospective design. Categorization into either STADT or LTADT groups was according to intention to treat and does not necessarily reflect the actual duration of ADT given. This designation was made to limit confounding factors that could have led to the decision to discontinue ADT early or proceed with ADT for longer than planned at the start of treatment. Despite this decision, few patients deviated from MitoPY1 ADT duration that was planned at the time of treatment initiation, with 94.8% of patients within the training cohort and 93.2% of patients within the validation cohort receiving treatment as planned. Although other factors may also contribute to
    testosterone recovery, including formulation and duration of ADT injection,31,32 this relationship was not specifically
    explored in our study. It is notable, however, that although the patients from the training cohort primarily received a similar formulation and duration of ADT, there was considerable variability in formulation choice and duration of ADT injection within the validation cohort. Despite these differences, the nomogram retained a high C index and ability to predict time to TR. Future study designs should incorporate testosterone values into their analysis plans to help provide prospective data to better determine time to recovery.
    Conclusions
    In this study, ADT duration, pretreatment testosterone level, BMI, age, and MitoPY1 predict for testosterone recovery in men treated with ADT and RT for localized prostate cancer. Using these factors, a predictive nomogram can estimate the likelihood of testosterone recovery and help counsel patients in a clinical setting.
    References
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    4. Bolla M, Collette L, Blank L, et al. Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): A phase III randomised trial. Lancet 2002;360:103-106.
    5. Alibhai SM, Breunis H, Timilshina N, et al. Impact of androgen-deprivation therapy on physical function and quality of life in men with nonmetastatic prostate cancer. J Clin Oncol 2010;28:5038-5045.
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    842 Spiegel et al. International Journal of Radiation Oncology Biology Physics
    7. Bong GW, Clarke HS Jr., Hancock WC, Keane TE. Serum testosterone recovery after cessation of long-term luteinizing hormone-releasing hormone agonist in patients with prostate cancer. Urology 2008;71: 1177-1180.
    9. Gulley JL, Aragon-Ching JB, Steinberg SM, et al. Kinetics of serum androgen normalization and factors associated with testosterone reserve after limited androgen deprivation therapy for nonmetastatic prostate cancer. J Urol 2008;180:1432-1437; discussion 1437.
    10. Hall MC, Fritzsch RJ, Sagalowsky AI, Ahrens A, Petty B, Roehrborn CG. Prospective determination of the hormonal response after cessation of luteinizing hormone-releasing hormone agonist treatment in patients with prostate cancer. Urology 1999;53:898-902; discussion 902-893.
    11. Murthy V, Norman AR, Shahidi M, et al. Recovery of serum testos-terone after neoadjuvant androgen deprivation therapy and radical radiotherapy in localized prostate cancer. BJU Int 2006;97:476-479.