Presentation Authors: Nishant Jain BS, Laura Bukavina MD MPH*, Kirtishri Mishra MD, Amr Mahran MD MS, Christopher Kondray MD, David Sheyn MD, Christina Buzzy PhD, Lee Ponsky MD, Kristina Garrels MD, Carvell Nguyen MD PhD, Cleveland, OH
Introduction: Androgen deprivation therapy (ADT) is commonly used for the management of localized and metastatic prostate cancer. There is mounting evidence that ADT may expedite loss of brain volume, which may hasten cognitive decline. In this study we aim to quantify the loss of cortical brain volume in patients on ADT.
Methods: We retrospectively analyzed baseline and follow up CT head scans of 14 men prior to and after initiation of ADT. Men underwent CT head imaging for non-trauma/ischemic indications. All CT imaging were reviewed using 3D planimetry software (3D Splicer Â®, Version 4.0). Brain, ventricular surface area and volumes were assessed via segmentation protocol. All volumes and surface areas were calculated using dedicated, automated software (Figure). Baseline socio-demographic variables, comorbidities, and risk factors were collected retrospectively. Paired t-test was utilized to assess change in brain volume prior to and after initiation of ADT
Results: A total of 14 patients were analyzed in the study. Mean age 74.36 yo (Â±13.76), with median ADT duration of 9.5 months (IQR 6.0, 16.25), with a median washout period of 11 months ( IQR 6.5, 20.25) prior to follow up CT scan. Overall, 5 (35.7%) and 9 (64.3%) were started on either Leuprolide acetate plus Bicalutamide, vs Leuprolide acetate alone, respectively. Additionally, 6 (42.9%) had oligo-metastatic disease to the bone at the time of ADT initiation. Compared to baseline CT imaging, patients on ADT experienced statistically significant brain volume loss (-33.465 cm3 (95% CI -62.487, -4.442), p=0.027)). Similarly, men on androgen deprivation experienced increase in ventricular volume (22.166 cm3 (95% CI -0.703, 45.035) p=0.056)). There was no difference in the surface area of the cortex or ventricles among the pre and post ADT head imaging
Conclusions: Our study found that men with prostate cancer experience significant cortical brain volume loss as well as ventricular volume expansion after initiation of androgen deprivation therapy.