Effect of androgen suppression on hemoglobin in prostate cancer patients undergoing salvage radiotherapy plus 2-year buserelin acetate for rising PSA after surgery.
OBJECTIVE
To examine the effect of 2-year androgen suppression (AS) on the pattern and extent of hemoglobin (Hb) change.


METHODS
The basis of this report was a Phase II study evaluating a combined treatment of salvage radiotherapy plus 2-year AS for a rising prostate-specific antigen level after surgery. Patients had laboratory tests performed, including Hb and serum testosterone, and answered a quality-of-life questionnaire (European Organization for Research and Treatment of Cancer Quality-of-life Questionnaire 30 item) at regular intervals during the AS and post-AS period. The pattern and extent of the change in Hb was analyzed in relation to the testosterone level. The clinical significance of the Hb change was evaluated with a correlation analysis between Hb and the three specific domains of the questionnaire (Global Health Status, Physical Functioning, and Fatigue).


RESULTS
Of a total of 74 accrued patients, 69 were identified as eligible for this report. The median patient age was 70 years. The median follow-up was 38.6 months. The mean Hb was 150.7 g/L at baseline and declined with radiotherapy by 5.9 g/L. The maximal Hb drop during AS was 16.0 g/L (p <0.0001), occurring at 16 months after the initiation of AS. Hb recovery in the post-AS period was slow. The decline and recovery of the mean Hb and hematocrit followed that of testosterone. The three quality-of-life domains did not show any significant correlation with the change in Hb.


CONCLUSIONS
Two-year AS resulted in a statistically significant drop in the mean Hb, but had no clinically apparent adverse effect. The pattern of Hb change was similar to that of testosterone change.
Chander
Sarat
S
Department of Radiation Oncology, Toronto Sunnybrook Regional Cancer Centre, University of Toronto, Toronto, ON, Canada.
Choo
Richard
R
Danjoux
Cyril
C
Morton
Gerard
G
Pearse
Andrew
A
Deboer
Gerrit
G
Szumacher
Ewa
E
Loblaw
Andrew
A
Cheung
Patrick
P
Woo
Tony
T
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002064:Buserelin / Q000627:therapeutic use*; D005221:Fatigue; D006304:Health Status; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000628:therapy*; D011788:Quality of Life; D016879:Salvage Therapy; D013739:Testosterone / Q000097:blood
D018931:Antineoplastic Agents, Hormonal; D006454:Hemoglobins; D013739:Testosterone; D002064:Buserelin