Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy.
OBJECTIVE
To determine the influence of radical prostatectomy (RP) and external beam radiation therapy (EBRT) on the hypothalamic pituitary axis of 120 men with clinically localized prostate cancer treated with RP or EBRT exclusively.


MATERIALS AND METHODS
120 patients with localized prostate cancer were enrolled. Ninety two patients underwent RP and 28 patients EBRT exclusively. We measured serum levels of luteinizing hormone, follicle stimulating hormone (FSH), total testosterone (T), free testosterone, and estradiol at baseline and at 3 and 12 months after treatment completion.


RESULTS
Patients undergoing RP were younger and presented a higher prostate volume (64.3 vs. 71.1 years, p<0.0001 and 55.1 vs. 36.5 g, p<0.0001; respectively). No differences regarding serum hormonal levels were found at baseline. Luteinizing hormone and FSH levels were significantly higher in those patients treated with EBRT at three months (luteinizing hormone 8,54 vs. 4,76 U/l, FSH 22,96 vs. 8,18 U/l, p<0,0001) while T and free testosterone levels were significantly lower (T 360,3 vs. 414,83ng/dl, p 0,039; free testosterone 5,94 vs. 7,5pg/ml, p 0,018). At 12 months FSH levels remained significantly higher in patients treated with EBRT compared to patients treated with RP (21,01 vs. 8,51 U/l, p<0,001) while T levels remained significantly lower (339,89 vs. 402,39ng/dl, p 0,03).


CONCLUSIONS
Prostate cancer treatment influences the hypothalamic pituitary axis. This influence seems to be more important when patients with prostate cancer are treated with EBRT rather than RP. More studies are needed to elucidate the role that prostate may play as an endocrine organ.
['Planas|J|J|', 'Celma|A|A|', 'Placer|J|J|', 'Maldonado|X|X|', 'Trilla|E|E|', 'Salvador|C|C|', 'Lorente|D|D|', 'Regis|L|L|', 'Cuadras|M|M|', 'Carles|J|J|', 'Morote|J|J|']
D000368:Aged D004958:Estradiol D005640:Follicle Stimulating Hormone D006801:Humans D007986:Luteinizing Hormone D008297:Male D008875:Middle Aged D011468:Prostatectomy D011471:Prostatic Neoplasms D012189:Retrospective Studies D013739:Testosterone
Prostate cancer Radical prostatectomy Testosterone Cáncer de próstata Gonadotrophin Gonadotropina Prostatectomía radical Radioterapia Radiotherapy Testosterona