Health Related Quality of Life Using Serum Testosterone as the Trigger to Re-Dose Long Acting Depot Luteinizing Hormone-Releasing Hormone Agonists in Patients with Prostate Cancer

Abstract

Health related quality of life was assessed in patients with prostate cancer on androgen suppression therapy re-dosed based on serum testosterone, and observations were confirmed regarding the safety, efficacy and cost per patient treated with this method of re-dosing luteinizing hormone-releasing hormone agonists. The study comprised 22 patients with prostate cancer prospectively enrolled in a control-crossover designed trial of dosing depot luteinizing hormone-releasing hormone agonist based on serum testosterone. Health related quality of life using the Expanded Prostate Index Composite and SF-36 instruments was the primary outcome assessed. Median duration of castrate testosterone was 5.5 months (range 3.5 to 10). Longer durations of castrate testosterone significantly correlated with lower pretreatment serum testosterone and smaller body mass index. No significant change from nadir prostate specific antigen was observed during castrate duration. The yearly cost of care was significantly decreased using the method of re-dosing based on serum testosterone ($3,567.90 versus $7,135.80). Short-term overall health related quality of life and patient satisfaction were significantly improved over baseline measurements. However, by study completion overall health related quality of life was equivalent regardless of the dosing method. Patient assessed health related quality of life improved in the short term and the cost of care decreased with no loss in the quality of care or patient satisfaction using serum testosterone as the trigger to re-dose 10.8 mg. goserelin in patients with prostate cancer on androgen suppression therapy.