[Correlation of change in prostate-specific antigen and testosterone following withdrawal of androgen ablation after combination of radiation and hormone therapy].
OBJECTIVE
We investigated retrospectively that change of serum testosterone and PSA concentrations following withdrawal of androgen ablation after combination of radiation and hormone therapy for prostate cancer.


METHODS
Among prostate cancer patients who were treated with combination of radiation and hormone therapy from 1992, 42 patients who were measured with time in the concentration of testosterone after withdrawal of androgen ablation were selected. Their median age was 76 years old (62-84), their median PSA was 13.2 ng/ml (1.4-215.3), and clinical stage consisted of T1 (12 patients), T2 (12 patients) and T3 (18 patients). They were divided into three groups by recovery of testosterone after withdrawal of androgen ablation and examined with change of PSA. Three groups consisted of castration-level group (testosterone: less than 1.0 ng/ml), low group (1.0-2.0 ng/ ml) and normal group (2.0 ng/ml and more).


RESULTS
There were 8 patients in castration-level group, 10 patients in low group and 24 patients in normal group. There were no significant differences in age, clinical stage and histological grade among each group. However, duration of hormone therapy in normal group was 4.7 months and shorter than durations in castration-level (38.5 months) and low group (26.6 months). The median time of the recovery to normal range of testosterone was 9.1 months. Only duration of hormone therapy influenced the recovery of testosterone in the multivariate analysis. Median changes of PSA after withdrawal of androgen ablation were 0 ng/ml (0-0.029) in castration-level group, 0.118 ng/ml (0-1.169) in low group and 0.427 ng/ml (0.047-4.358) in normal group. Change of PSA in normal group was significantly higher than castration-level and low groups. If the patients were defined as failure in whom PSA was rising during follow-up, positive or negative predictive value to predict failure, when setting a cutoff value to 0.2 ng/ml of PSA rise-width, were better than other cutoff values (0.1 or 0.3 ng/ml).


CONCLUSIONS
Among prostate cancer patients treated with combination of radiation and hormone therapy, PSA is went up in some of them with recovery of testosterone after withdrawal androgen ablation. Rise-width of PSA may be important for one of the predictors of failure with measurement of testosterone.
Hashine
Katsuyoshi
K
Department of Urology, National Organization Shikoku Cancer Center, Matsuyama, Japan.
Numata
Kosaku
K
Azuma
Koji
K
Sumiyoshi
Yoshiteru
Y
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000532:radiotherapy; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood*
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D013739:Testosterone; D017430:Prostate-Specific Antigen