title: Hypogonadism following prostate-bed radiation therapy for prostate carcinoma.
abstract: BACKGROUND
  The degree of testicular damage resulting from primary treatment of prostate carcinoma by external beam radiation therapy (EBRT) to the prostate bed has not been determined. If significant testicular damage has occurred, the resulting endocrine changes may result in modified tumor behavior, contribute to postradiation impotence, and may aggravate other signs and symptoms of hypogonadism, potentially influencing a patient's choice of primary treatment for his tumor.
  
  
  METHODS
  Three to eight years after primary treatment for localized prostate carcinoma, serologic evaluation for hypogonadism was undertaken in 33 men who had received EBRT and in 55 similar men who had received radical prostatectomy (RP). No subjects had developed recognized tumor recurrence, and none had undergone hormonal treatment since primary therapy.
  
  
  RESULTS
  Among men of similar age, prior treatment with EBRT was associated with significantly more frequent hypogonadism than prior treatment with RP. In men with EBRT, total testosterone levels averaged 27.3% less, free testosterone levels 31.6% less, dihydrotestosterone levels 33.4% less, luteinizing hormone (LH) levels 52.7% greater, and follicle-stimulating hormone (FSH) levels 100% greater than those values in men who had prior treatment with RP. Differences between postradiation and postsurgical men in LH and FSH levels were most prominent in men older than 70 years.
  
  
  CONCLUSIONS
  Three to eight years after primary treatment for prostate carcinoma, striking hormone differences were present between men who had received EBRT to the prostate bed and those with prior RP. These differences strongly suggested that prominent and permanent testicular damage was sustained during EBRT, frequently severe enough to cause hypogonadism.
authors.affiliation: Mercy Medical Center, Redding, California 96001, USA. hwdaniel@aol.com
authors.forename: H W
authors.initials: HW
authors.lastname: Daniell
authors.forename: J C
authors.initials: JC
authors.lastname: Clark
authors.forename: S E
authors.initials: SE
authors.lastname: Pereira
authors.forename: Z A
authors.initials: ZA
authors.lastname: Niazi
authors.forename: D W
authors.initials: DW
authors.lastname: Ferguson
authors.forename: S R
authors.initials: SR
authors.lastname: Dunn
authors.forename: M L
authors.initials: ML
authors.lastname: Figueroa
authors.forename: P T
authors.initials: PT
authors.lastname: Stratte
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D013196:Dihydrotestosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005300:Fertility Agents, Female / Q000097:blood / Q000378:metabolism; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000378:metabolism; D007987:Gonadotropin-Releasing Hormone / Q000097:blood / Q000378:metabolism; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000209:etiology*; D007986:Luteinizing Hormone / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000097:blood / Q000209:etiology*; D013737:Testis / Q000473:pathology / Q000528:radiation effects*; D013739:Testosterone / Q000097:blood
chemical_list: D005300:Fertility Agents, Female; D013196:Dihydrotestosterone; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone