Prostate-specific antigen kinetics and biochemical control following stereotactic body radiation therapy, high dose rate brachytherapy, and low dose rate brachytherapy: A multi-institutional analysis of 3502 patients
| Autor: | Naomi Y. Jiang, Nicholas G. Nickols, Brandon A. Mahal, Sean P. Collins, Ye Yuan, Richard G. Stock, A.T. Dang, Eric J. Lehrer, Nicholas D. Prionas, Michael L. Steinberg, Nicholas G. Zaorsky, Rebecca Levin-Epstein, Minsong Cao, Constantine Mantz, Leszek Miszczyk, A. Napieralska, Ryan Cook, Amar U. Kishan, J. Karen Wong, Mark K. Buyyounouski, D. Jeffrey Demanes, Agnieszka Namysł-Kaletka, Daniel E. Spratt, Hilary P. Bagshaw, Nima Aghdam, Alan J. Katz, David Shabsovich, Albert J. Chang, Matthew Rettig, Eric M. Horwitz, William C. Jackson, Patrick A. Kupelian, Simeng Suy |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Stereotactic body radiation therapy medicine.medical_treatment Brachytherapy Urology Radiosurgery 030218 nuclear medicine & medical imaging Androgen deprivation therapy 03 medical and health sciences Prostate cancer 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Retrospective Studies business.industry Prostatic Neoplasms Androgen Antagonists Radiotherapy Dosage Hematology Prostate-Specific Antigen medicine.disease Low-Dose Rate Brachytherapy High-Dose Rate Brachytherapy Radiation therapy Prostate-specific antigen Kinetics Oncology 030220 oncology & carcinogenesis business |
| Zdroj: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 151 |
| ISSN: | 1879-0887 |
| Popis: | Stereotactic body radiation therapy (SBRT), low dose rate brachytherapy (LDR-BT) and high dose rate brachytherapy (HDR-BT) are ablative-intent radiotherapy options for prostate cancer (PCa). These vary considerably in dose delivery, which may impact post-treatment prostate-specific antigen (PSA) patterns and biochemical control. We compared PSA kinetics between SBRT, HDR-BT, and LDR-BT, and assessed their relationships to biochemical recurrence-free survival (BCRFS).Retrospective PSA data were analyzed for 3502 men with low-risk (n = 2223; 63.5%), favorable intermediate-risk (n = 869; 24.8%), and unfavorable intermediate-risk (n = 410; 11.7%) PCa treated with SBRT (n = 1716; 49.0%), HDR-BT (n = 512; 14.6%), or LDR-BT (n = 1274; 36.4%) without upfront androgen deprivation therapy at 10 institutions from 1990 to 2017. We compared nadir PSA (nPSA), time to nPSA, achievement of nPSA0.2 ng/mL and0.5 ng/mL, rates of nPSA0.4 ng/mL at 4 years, and BCRFS.Median follow-up was 72 months. Median nPSA and nPSA0.2 ng/mL were stratified by risk group (interaction p ≤ 0.001). Median nPSA and time to nPSA were 0.2 ng/mL at 44 months after SBRT, 0.1-0.2 ng/mL at 37 months after HDR-BT, and 0.01-0.2 ng/mL at 51 months after LDR-BT (mean log nPSA p ≤ 0.009 for LDR-BT vs. SBRT or HDR-BT for low/favorable intermediate-risk). There were no differences in nPSA0.4 ng/mL at 4 years (p ≥ 0.51). BCRFS was similar for all three modalities (p ≥ 0.27). Continued PSA decay beyond 4 years was predictive of durable biochemical control.LDR-BT led to lower nPSAs with longer continued decay compared to SBRT and HDR-BT, but no differences in BCRFS. |
| Databáze: | OpenAIRE |
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