Testosterone recovery following androgen suppression and prostate radiotherapy (TRANSPORT): Updated individual patient data meta-analyses from the MARCAP consortium.
Bibliographic record
Abstract
5096 Background: Time to testosterone recovery (TR) following androgen deprivation therapy (ADT) and radiotherapy for prostate cancer varies following cessation of ADT. We aimed to quantify the association between time to TR and duration of ADT and patient age. Methods: We identified prospective randomized trials of prostate radiotherapy and ADT in the Meta-Analysis of Randomized trials in Cancer of the Prostate (MARCAP) consortium for which prospectively collected serial testosterone values were available. The time to non-castrate TR (NCTR) (>1.7ng/mL), non-hypogonadal TR (NHTR) (>8.0ng/mL) and full TR (FTR) (>10.5ng/mL) were estimated from the end date of prescribed ADT using the Kaplan Meier method. Cox regression was used to evaluate the differences in time to TR for men aged <65 years and ≥65 years for each duration of ADT. Interaction effects between ADT duration and patient age on TR were evaluated. Results: 2628 men from 5 trials (TROG 9601, TROG 0304, PCSIII, PCSIV, and Ottawa-01) met the inclusion criteria for analysis. Of these, 236, 1485, 731, and 176 men had 3-, 6-, 18-, and 36-months of ADT respectively. 1502 (57%) men had baseline (pre-ADT) testosterone data available, of which 99% (1494/1502) had non-castrate testosterone (>1.7ng/mL), and 78% (1178/1502) had normal testosterone (>10.5ng/mL) at baseline. At last follow-up, there were 96% (2522/2628), 77% (2035/2628) and 65% (1700/2628) of men who had NCTR, NHTR and FTR respectively. The median time (range) to NCTR was 1.9 (0.2-60), 6.2 (0.0-92), 6.3 (0.0-92), and 15.7 (0.1-75) months for men who had 3-, 6-, 18- and 36-months of ADT, respectively. The median time (range) to NHTR was 2.5 (0.4-73), 11.2 (0.1-93), 17.7 (0.2-92), and 53.4 (5.3-76) months for men who had 3-, 6-, 18- and 36-months of ADT, respectively. The median time (range) to FTR was 5.8 (0.4-72), 16.7 (0.3-95), and 26.0 (0.2-90) for men who had 3-, 6-, and 18-months of ADT, respectively, while the median time to FTR was not reached in men who had 36-months of ADT. In men who had 6-months of ADT, men aged ≥65 years were 35% (95%CI=26-43%) less likely to have FTR compared to men aged <65 years, while for those who had 18-months of ADT, men aged ≥ 65 years were 52% (95%CI=41-60%) less likely to have FTR compared to men aged < 65 years. There was no statistically significant interaction between the effect of ADT duration and age on the time to FTR (interaction P=0.07 for the entire cohort). Conclusions: In this updated individual patient-data meta-analysis of prospectively collected serial testosterone data from 5 randomized trials, substantial delay in FTR in men who had longer duration of ADT was observed, consistent with prior analyses. Approximately 1-in-3 men did not have FTR, which may have life-long impacts on their quality of life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.038 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.039 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".