使用促性腺激素释放激素激动剂进行雄激素剥夺治疗 (ADT) 后，睾酮恢复 (TR) 的时间差异很大。我们评估了接受明确放射治疗和 ADT 治疗前列腺癌的患者的 TR 动力学和有效去势期的肿瘤学影响。我们从 ADT 放射治疗的随机对照试验中获得了个体患者数据，并从 MARCAP 联盟前瞻性地收集了一系列睾酮数据。我们估计了每个规定的 ADT 持续时间的非去势 TR (>1.7 nmol/l) 和非性腺功能减退 TR (>8.0 nmol/l) 的时间，并绘制了相应的列线图。通过多变量 Cox 回归评估任何给定 ADT 持续时间的有效去势期与无转移生存期 (MFS) 之间的关联。我们进行了三次样条分析来评估非线性关联。我们在分析中纳入了来自 5 项试验的 1444 名男性，其中 115 人接受了 4 个月的 ADT，880 人接受了 6 个月的 ADT，353 人接受了 18 个月的 ADT，36 人接受了 28 个月的 ADT，60 人接受了 36 个月的 ADT 。非去势 TR 和非性腺功能减退 TR 的时间因 ADT 持续时间的不同而有很大差异。较高的基线睾酮水平和较低的年龄与较高的 TR 可能性相关（两者均 p < 0.001）。 Cox 回归上任何 ADT 持续时间的有效去势期与 MFS 都不是线性相关的。三次样条分析显示，接受 6 个月 ADT 的男性获得 MFS 益处的最佳有效去势期为 10.6 个月，接受 18 个月 ADT 的男性则为 18 个月。达到 TR 的时间根据 ADT 持续时间、基线睾酮、和年龄。有效去势期和 MFS 之间的关系可能是非线性的，较长的有效去势期对接受 6 个月 ADT 的男性有帮助。版权所有 © 2024 欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。

Time to testosterone recovery (TR) following androgen deprivation therapy (ADT) with gonadotropin-releasing hormone agonists varies widely. We evaluate TR kinetics and the oncological impact of an effective castration period in patients receiving definitive radiotherapy and ADT for prostate cancer.We obtained individual patient data from randomized controlled trials of radiotherapy with ADT and prospectively collected serial testosterone data from the MARCAP Consortium. We estimated the times to noncastrate TR (>1.7 nmol/l) and nonhypogonadal TR (>8.0 nmol/l) were estimated for each prescribed ADT duration, and developed corresponding nomograms. The association between effective castration period and metastasis-free survival (MFS) for any given ADT duration was evaluated via multivariable Cox regression. We conducted cubic spline analyses to assess nonlinear associations.We included 1444 men from five trials in the analysis, of whom 115 received 4 mo, 880 received 6 mo, 353 received 18 mo, 36 received 28 mo, and 60 received 36 mo of ADT. Times to noncastrate TR and to nonhypogonadal TR varied considerably by ADT duration. Higher baseline testosterone and lower age were associated with a higher likelihood of TR (p < 0.001 for both). Effective castration period was not linearly associated with MFS for any ADT duration on Cox regression. Cubic spline analysis revealed that the optimal effective castration period for an MFS benefit was 10.6 mo for men who received 6 mo of ADT and 18 mo for men who received 18 mo of ADT.Time to TR varies according to the ADT duration, baseline testosterone, and age. The relationship between effective castration period and MFS may be nonlinear, with a longer effective castration period being helpful for men receiving 6 mo of ADT.Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.