The Study Of Monitoring Serum Testosterone To Guiding Endocrine Therapy Of Prostate Cancer

ObjectiveIn order to demonstrate the value of serum testosterone in guiding hormonal therapy of prostate carcinoma, this research is to discuss the differentiation between combined androgen blocked method and hormonal therapy with serum testosterone monitoring. We want to explore a new method and a good monitoring index for the endocrine therapy.MethodsBy random control experiment, we studied 45 cases admitted with prostate carcinoma in urology department of the second hospital of Tianjin Medical University from Jan. 1.2003 to March. 10.2006. All patients were performed with endocrine therapy, and randomly divided into two groups: experiment group(EG) and control group(CG). EG(n=23) was administrated with Zoladex 3. 6mg IH once and Casodex 50mg Po Qd, with the level of serum testosterone monitored simultaneously. Zoladex was used continuously until serum testosterone declined to castration. CG (n=22) was administrated with Zoladex 3. 6mg IH once a month and Casodex 50mg Po Qd. The method of monitoring serum testosterone: test the basic level of serum testosterone before treatment. Then test it consecutively. Both groups were monitored the serum PSA, QOL, clinical symptom, side effects and expense. The treatment was terminated when the prostate carcinoma developed into HRPC.ResultAll patients were followed up 5-18 months. None of the cases was lost. The average PSA , T and QOL of patients is 44.14± 13. 36 ng/dl, 41. 76 ±11.02ng/dL, 74. 39±4. 57 in EG and 45.17±1.43 ng/dl, 24.65±0.88ng/dL, 59. 38 + 7. 31 in CG respectively. The subjective symptoms, objective signs were reduced. The serum PSA of two group has no significant difference(P >0. 05) before and after treatment. The QOL of EG is higher than CG (P<0. 05). Side effects involved hyposexuality, decrease food appetite, hot flash, night sweats, fatigue and digestive system syndromes. Side effect of EG is fewer than CG(P<0.05).The expense of EG is fewer than CG(P<0. 05). The average expense of EG and CG is 6504+504 yuan and 8935 + 327 yuan respectively (P<0.05).Conclusion1. The monitoring of serum testosterone, as a quantitative target of castration, can guide clinical administration and together with serum PSA can evaluate the prognosis of the patients during the endocrine therapy of prostate cancer.2. The monitoring of serum testosterone can personalize the administration, decrease the doses, reduce the side effects and cut down the expenditure.