Prostate specific antigen bounce is related to overall survival in prostate brachytherapy.
| Autor: | Hinnen KA; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. KAHinnen@Gmail.com, Monninkhof EM, Battermann JJ, van Roermund JG, Frank SJ, van Vulpen M |
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| Jazyk: | angličtina |
| Zdroj: | International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2012 Feb 01; Vol. 82 (2), pp. 883-8. Date of Electronic Publication: 2011 Feb 06. |
| DOI: | 10.1016/j.ijrobp.2010.11.049 |
| Abstrakt: | Purpose: To investigate the association between prostate specific antigen (PSA) bounce and disease outcome after prostate brachytherapy. Methods and Materials: We analyzed 975 patients treated with (125)I implantation monotherapy between 1992 and 2006. All patients had tumor Stage ≤ 2c, Gleason score ≤ 7 prostate cancer, a minimum follow-up of 2 years with at least four PSA measurements, and no biochemical failure in the first 2 years. Median follow-up was 6 years. Bounce was defined as a PSA elevation of +0.2 ng/mL with subsequent decrease to previous nadir. We used the Phoenix +2 ng/mL definition for biochemical failure. Additional endpoints were disease-specific and overall survival. Multivariate Cox regression analysis was performed to adjust for potential confounding factors. Results: Bounce occurred in 32% of patients, with a median time to bounce of 1.6 years. More than 90% of bounces took place in the first 3 years after treatment and had disappeared within 2 years of onset. Ten-year freedom from biochemical failure, disease-specific survival, and overall survival rates were, respectively, 90%, 99%, and 88% for the bounce group and 70%, 93%, and 82% for the no-bounce group. Only 1 patient (0.3%) died of prostate cancer in the bounce group, compared with 40 patients (6.1%) in the no-bounce group. Adjusted for confounding, a 70% biochemical failure risk reduction was observed for patients experiencing a bounce (hazard ratio 0.31; 95% confidence interval 0.20-0.48). Conclusions: A PSA bounce after prostate brachytherapy is strongly related to better outcome in terms of biochemical failure, disease-specific survival, and overall survival. (Copyright © 2012 Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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