Pre-treatment testosterone levels: significance in androgen deprivation therapy.
From June 1982 to February 1985, 53 patients with stage D2 carcinoma of the prostate confirmed by tissue biopsy, elevated prostatic acid phosphatase and a positive bone scan were initiated on androgen deprivation therapy. Before commencement of treatment all patients underwent determination of serum testosterone levels at 8 a.m. Of the patients 23 received 200 mcg. buserelin per day, 17 received 1 mg. diethylstilbestrol 3 times daily, 6 received 40 mg. megestrol acetate 4 times daily, 2 received 1 mg. leuprolide per day and 5 underwent bilateral orchiectomy. Evaluation of the best response in each patient revealed 3 (6 per cent) complete and 17 (32 per cent) partial responses, while 22 patients (41 per cent) remained stable and 11 (21 per cent) had progression. Pre-treatment serum testosterone levels ranged from 150 to 879 ng. per dl. The mean serum testosterone level in patients having a complete response was 524 +/- 18.04 ng. per dl. The mean in the progression group was 279.4 +/- 110.1 ng. per dl. This difference was not statistically significant owing to the large standard deviation in the progression group. However, of the 15 patients who had a pre-treatment serum testosterone level of more than 500 ng. per dl. only 1 (7 per cent) had progression. None of the patients whose pre-treatment testosterone level was less than 200 ng. per dl. had objective tumor regression. Our study suggests that pre-treatment serum testosterone levels may predict the probability of a satisfactory response to androgen deprivation therapy.
D000368:Aged; D000369:Aged, 80 and over; D002064:Buserelin / Q000627:therapeutic use; D002277:Carcinoma / Q000097:blood / Q000628:therapy*; D004054:Diethylstilbestrol / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D016729:Leuprolide; D008297:Male; D008535:Megestrol / Q000031:analogs & derivatives / Q000627:therapeutic use; D019290:Megestrol Acetate; D008875:Middle Aged; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000628:therapy*; D013739:Testosterone / Q000097:blood*
D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D004054:Diethylstilbestrol; D008535:Megestrol; D016729:Leuprolide; D002064:Buserelin; D019290:Megestrol Acetate