title: Effect of androgen deprivation therapy in the thyroid function test of patients with prostate cancer.
abstract: We have assessed the effect of androgen deprivation therapy (ADT) in the thyroid function test in prostate cancer patients. Serum levels of tri-iodothyronine (T3), thyroxine (T4), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were determined in a cross-sectional study that included 279 patients diagnosed with prostate cancer. A subset of 96 patients free of prostate-specific antigen relapse after radical prostatectomy became a control group and 183 patients under continuous ADT formed the study group. Sixty-four patients out of the study group were treated with luteinizing hormone-releasing hormone (LHRH) agonist and 119 with LHRH agonist plus bicalutamide. The average time of ADT was 42.5 months (3-218). Results were as follows. Mean T3 level was 122.7 ng/dl (72.6-213.0) in the control group and 123.8 ng/dl (64.4-228.2) in patients under ADT, p=0.472. Mean T4 level was 7.66 (1.81-4.30) and 7.66 microg/dl (3.60-13.30), respectively, p=0.884. Mean TSH level was 1.58 (0.44-11.70) and 1.81 mU/dl (0.15-6.58), respectively, p=0.007. Mean FT4 level was 1.24 (0.80-1.90) and 1.18 ng/dl (0.80-1.90), respectively, p=0.018. No statistically significant differences between the T3, T4, TSH and FT4 serum levels were detected according to the modality of ADT. The serum level of TSH was higher than 5 mU/l in six patients (2.1%); however, all cases had a normal FT4 serum level. This mild hypothyroidism was detected in two of the 96 patients of the control group (2.1%) and in four of the 183 under ADT (2.2%). Our data show that ADT seems to alter the thyroid function test. A statistically significant increase in TSH serum level and a decrease in FT4 serum level were detected in patients under ADT. However, only a mild hypothyroidism was detected in about 2% of the patients with prostate cancer, independently of ADT.
authors.affiliation: Departments of Urology, Vall d'Hebron Hospital, Autònoma University of Barcelona, Barcelona, Spain. jmorote@vhebron.net
authors.forename: Juan
authors.initials: J
authors.lastname: Morote
authors.forename: Salvador
authors.initials: S
authors.lastname: Esquena
authors.forename: Anna
authors.initials: A
authors.lastname: Orsola
authors.forename: Carlos
authors.initials: C
authors.lastname: Salvador
authors.forename: Enrique
authors.initials: E
authors.lastname: Trilla
authors.forename: Luis
authors.initials: L
authors.lastname: Cecchini
authors.forename: Carles X
authors.initials: CX
authors.lastname: Raventós
authors.forename: Jacques
authors.initials: J
authors.lastname: Planas
authors.forename: Roberto
authors.initials: R
authors.lastname: Catalán
authors.forename: Jaume
authors.initials: J
authors.lastname: Reventós
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000813:Anilides / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007037:Hypothyroidism; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000378:metabolism; D013974:Thyroxine / Q000378:metabolism; D014105:Tosyl Compounds; D014284:Triiodothyronine / Q000378:metabolism
chemical_list: D000726:Androgen Antagonists; D000813:Anilides; D009570:Nitriles; D014105:Tosyl Compounds; D014284:Triiodothyronine; D007987:Gonadotropin-Releasing Hormone; D013972:Thyrotropin; C053541:bicalutamide; D017430:Prostate-Specific Antigen; D013974:Thyroxine