Hipogonadismo prolongado tras la suspensión de tratamiento hormonal en pacientes con cáncer de próstata
Prolonged hypogonadism after cessation of androgen deprivation therapy for prostate cancer
I. Federico Rodríguez-Rubio Cortadellas**
, Miguel E. Jiménez Romero, Delfín González Moreno, Sofía Garrido Insúa
Autor para correspondencia
frubio@pulso.com
Correspondencia autor: Dr. Federico I. Rodríguez-Rubio Cortadellas Servicio de Urología. Hospital Universitario Puerto Real Carretera Nacional IV, Km 665 - 11510 Puerto Real, Cádiz Tel.: 956 005 000
Correspondencia autor: Dr. Federico I. Rodríguez-Rubio Cortadellas Servicio de Urología. Hospital Universitario Puerto Real Carretera Nacional IV, Km 665 - 11510 Puerto Real, Cádiz Tel.: 956 005 000
Área de Medicina Preventiva. Facultad de Medicina. Universidad de Cádiz, España
José P. Novalbos Ruiz*
* Servicio de Urología. Hospital Universitario Puerto Real. Departamento de Cirugía. Universidad de Cádiz, España
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"apellidos" => "Federico Rodríguez-Rubio Cortadellas" "email" => array:1 [ 0 => "frubio@pulso.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Miguel E." "apellidos" => "Jiménez Romero" ] 2 => array:2 [ "nombre" => "Delfín" "apellidos" => "González Moreno" ] 3 => array:2 [ "nombre" => "Sofía" "apellidos" => "Garrido Insúa" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Área de Medicina Preventiva. Facultad de Medicina. Universidad de Cádiz, España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "**" "correspondencia" => "Correspondencia autor: Dr. Federico I. Rodríguez-Rubio Cortadellas Servicio de Urología. Hospital Universitario Puerto Real Carretera Nacional IV, Km 665 - 11510 Puerto Real, Cádiz Tel.: 956 005 000" ] ] ] 1 => array:3 [ "autoresLista" => "José P. Novalbos Ruiz" "autores" => array:1 [ 0 => array:3 [ "nombre" => "José P." "apellidos" => "Novalbos Ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Urología. Hospital Universitario Puerto Real. Departamento de Cirugía. Universidad de Cádiz, España" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prolonged hypogonadism after cessation of androgen deprivation therapy for prostate cancer" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec89062" "palabras" => array:5 [ 0 => "Cáncer de próstata" 1 => "Supresión androgénica intermitente" 2 => "Testosterona" 3 => "Antígeno prostático específico" 4 => "Estudio prospectivo" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec89063" "palabras" => array:5 [ 0 => "Prostate cancer" 1 => "Intermittent androgen supression" 2 => "Testosterone" 3 => "Prostate-specific antigen" 4 => "Prospective studies" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Estudiar los niveles de LH, testosterona y PSA tras suspender el tratamiento prolongado con análogos LH-RH</p> <span class="elsevierStyleSectionTitle">Material y Método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudió la evolución hormonal de 29 pacientes a los que se les retiró el tratamiento. Los pacientes previamente habían seguido tratamiento con análogo LH-RH por más de un año y con LH<2 mUI/mL y testosterona <2,8 ng/mL. Se determinó mensualmente la LH, testosterona y PSA junto con valoración clínica. Se reinicia el tratamiento y el tiempo de seguimiento finaliza ante la presencia de progresión clínica y/o PSA ? 10 ng/mL. Se realizó descripción de la cohorte, el cálculo de supervivencia mediante Kaplan-Meier y regresión de Cox.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El tiempo medio sin tratamiento de la serie fue de 35 meses (IC 95% 15,7-54,2 meses). El 17% de los pacientes presentaron hipogonadismo prolongado (>24 meses). La recuperación del eje LH-T-PSA, cuando se produjo, siguió la secuencia esperada. Las variables que influyeron en el tiempo de recuperación del PSA fueron el PSA pretratamiento y la asociación de antiandrógeno.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Tras retirar el tratamiento prolongado con análogos LH-RH la mayoría de los pacientes recuperan los niveles de LH-T-PSA si bien un subgrupo se mantienen hipogonádicos más de 24 meses. Palabras clave: Cáncer de próstata. Supresión androgénica intermitente. Testosterona. Antígeno prostático específico. Estudio prospectivo.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To study the levels of LH, testosterone and PSA after suspending prolonged treatment with LH-RH analogs.</p> <span class="elsevierStyleSectionTitle">Materials and Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Hormonal evolution was studied in 29 patients from whom treatment had been withdrawn. The patients had previously been receiving treatment with LH-RH analog for more than one year, and with LH< 2 mUI/mL and testosterone <2.8 ng/mL. LH, testosterone and PSA were determined monthly, together with clinical assessment. The treatment was re-initiated and the period of monitoring ended before the presence of clinical progression and/or PSA ? 10 ng/mL. The cohort was described and survival was calculated using Kaplan-Meier and Cox regression.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The mean period of time without treatment for the series was 35 months (CI 95%, 15.7-54.2 months). Prolonged hypogonadism (> 24 months) was presented by 17% of the patients. The recovery of the LH-T-PSA axis, when it occurred, followed the expected sequence. The variables that influenced the period of recovery of the PSA were the PSA pretreatment and the association of an antiandrogen.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">After withdrawing the prolonged treatment with LH-RH analogs, most of the patients recovered the levels of LH-T-PSA, although a subgroup remained hypogonadic for more than 24 months.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| 2019 Octubre | 0 | 10 | 10 |
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| 2019 Agosto | 0 | 7 | 7 |
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| 2019 Marzo | 0 | 2 | 2 |
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| 2017 Octubre | 4 | 4 | 8 |
| 2017 Septiembre | 9 | 5 | 14 |
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| 2017 Marzo | 20 | 21 | 41 |
| 2017 Febrero | 10 | 6 | 16 |
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| 2016 Noviembre | 16 | 5 | 21 |
| 2016 Octubre | 32 | 8 | 40 |
| 2016 Septiembre | 12 | 7 | 19 |
| 2016 Agosto | 10 | 2 | 12 |
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| 2016 Abril | 17 | 17 | 34 |
| 2016 Marzo | 25 | 24 | 49 |
| 2016 Febrero | 17 | 23 | 40 |
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| 2015 Octubre | 20 | 23 | 43 |
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| 2015 Agosto | 10 | 11 | 21 |
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| 2015 Abril | 16 | 15 | 31 |
| 2015 Marzo | 17 | 15 | 32 |
| 2015 Febrero | 1 | 8 | 9 |
| 2015 Enero | 12 | 5 | 17 |
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| 2014 Octubre | 11 | 4 | 15 |
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| 2014 Agosto | 5 | 1 | 6 |
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| 2014 Febrero | 7 | 3 | 10 |
| 2014 Enero | 4 | 3 | 7 |
| 2013 Diciembre | 4 | 2 | 6 |
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| 2013 Octubre | 13 | 16 | 29 |
| 2013 Septiembre | 8 | 19 | 27 |
| 2013 Agosto | 7 | 13 | 20 |
| 2013 Julio | 4 | 3 | 7 |
| 2009 Junio | 331 | 0 | 331 |
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