br patient is also at risk for
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 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.
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.
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842 Spiegel et al. International Journal of Radiation Oncology Biology Physics
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