Adverse Effects of Androgen Deprivation Therapy on Persistent Genitourinary Complications After Carbon Ion Radiotherapy for Prostate Cancer

Background This study aimed to explain the dynamics of prostate-specific antigen (PSA) levels in patients with prostate cancer who were treated with carbon ion radiotherapy (CIRT) and neoadjuvant androgen-deprivation therapy (ADT). Methods Eighty-five patients with intermediate-risk prostate cancer who received CIRT and neoadjuvant ADT from December 2015 to December 2017 were analyzed in the present study. The total dose of CIRT was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. The PSA bounce was defined as a ≥0.4 ng/ml increase of PSA levels from the nadir, followed by any decrease. PSA failure was defined using the Phoenix criteria. Results The median patient age was 68 (range, 48–81) years. The median follow-up duration was 33 (range, 20–48) months. The clinical T stage was T1c, T2a, and T2b in 27, 44, and 14 patients, respectively. The Gleason score was 6 in 3 patients and 7 in 82 patients. The median pretreatment PSA level was 7.37 (range, 3.33–19.0) ng/ml. All patients received neoadjuvant ADT for a median of 6 (range, 2–117) months. PSA bounces were observed in 39 patients (45.9%), occurring a median of 12 (range, 6–30) months after CIRT. PSA failure was observed in eight patients (9.4%), occurring a median of 21 (range, 15–33) months after CIRT. The 3-year PSA failure-free survival rate was 88.5%. No clinical recurrence was observed during the follow-up period. Younger age and lower T stage were significant predictors of PSA bounce. Younger age was a significant predictor of PSA failure. Conclusions In this study, we identified the significant predictors of the occurrence of PSA bounce and failure. Further follow-up is needed to reveal the clinical significance of PSA dynamics.

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Review of major adverse effects of androgen-deprivation therapy in men with prostate cancer

Cancer ◽

10.1002/cncr.24283 ◽

2009 ◽

Vol 115 (11) ◽

pp. 2388-2399 ◽

Cited By ~ 188

Author(s):

Lockwood G. Taylor ◽

Steven E. Canfield ◽

Xianglin L. Du

Keyword(s):

Prostate Cancer ◽

Adverse Effects ◽

Androgen Deprivation Therapy ◽

Androgen Deprivation

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Induced testosterone deficiency: from clinical presentation of fatigue, erectile dysfunction and muscle atrophy to insulin resistance and diabetes

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci.2011.131 ◽

2011 ◽

Vol 8 (1) ◽

Cited By ~ 3

Author(s):

George Yu ◽

Abdulmaged M. Traish

Keyword(s):

Prostate Cancer ◽

Insulin Resistance ◽

Erectile Dysfunction ◽

Adverse Effects ◽

Androgen Deprivation Therapy ◽

Androgen Deprivation ◽

The Past ◽

Research Findings ◽

The Relationship

AbstractOver the past 60 years, androgen deprivation therapy has been the mainstay of treatment of metastatic prostate cancer. However, research findings suggest that androgen deprivation therapy inflicts serious adverse effects on overall health and reduces the quality of life. Among the adverse effects known to date are insulin resistance, diabetes, metabolic syndrome fatigue, erectile dysfunction, and cardiovascular disease. In this clinical perspective, we discuss the relationship between induced androgen deficiency and a host of pathologies in the course of treatment with androgen deprivation therapy for prostate cancer patients.

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Effects of Exercise on Treatment-Related Adverse Effects for Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Systematic Review

Journal of Clinical Oncology ◽

10.1200/jco.2013.49.5523 ◽

2014 ◽

Vol 32 (4) ◽

pp. 335-346 ◽

Cited By ~ 141

Author(s):

Jason R. Gardner ◽

Patricia M. Livingston ◽

Steve F. Fraser

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Systematic Review ◽

Adverse Effects ◽

Androgen Deprivation Therapy ◽

Bone Health ◽

Cardiometabolic Risk ◽

Androgen Deprivation ◽

Cochrane Library

Purpose Androgen-deprivation therapy is a commonly used treatment for men with prostate cancer; however, the adverse effects can be detrimental to patient health and quality of life. Exercise has been proposed as a strategy for ameliorating a range of these treatment-related adverse effects. We conducted a systematic review of the literature regarding the effects of exercise on treatment-related adverse effects in men receiving androgen-deprivation therapy for prostate cancer. Methods An online electronic search of the Cochrane Library, EMBASE, MEDLINE, CINAHL, SPORTDiscus, and Health Source databases was performed to identify relevant peer-reviewed articles published between January 1980 and June 2013. Eligible study designs included randomized controlled trials as well as uncontrolled trials with pre- and postintervention data. Information was extracted regarding participant and exercise intervention characteristics as well as the effects of exercise on bone health, body composition, physical performance, cardiometabolic risk, fatigue, and quality of life. Results Ten studies were included, with exercise interventions involving aerobic and/or resistance training. Exercise training demonstrated benefits in muscular strength, cardiorespiratory fitness, functional task performance, lean body mass, and fatigue, with inconsistent effects observed for adiposity. The impact of exercise on bone health, cardiometabolic risk markers, and quality of life are currently unclear. Conclusion Among patients with prostate cancer treated with androgen-deprivation therapy, appropriately prescribed exercise is safe and may ameliorate a range of treatment-induced adverse effects. Ongoing research of high methodologic quality is required to consolidate and expand on current knowledge and to allow the development of specific evidence-based exercise prescription recommendations.

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