Prostate Antigen Levels in Locally Advanced Prostate Cancer Patients Treated with High Energy Neutrons at Fermilab

Journal Article · Mon Jan 01 00:00:00 EST 1990 · Int.J.Radiat.Oncol.Biol.Phys.

DOI:https://doi.org/10.1016/0360-3016(90)90851-A· OSTI ID:1418792

Saroja, K. R. ^[1]; Cohen, L. ^[1]; Hendrickson, F. R. ^[1]; Mansell, JoAnne ^[2]

---

1. Unlisted, US, IL
2. Fermilab

The prostate specific antigen values were analyzed retrospectively for prognostic implications in thirty-nine locally advanced (Stages C and D1) prostate cancer patients treated using high energy neutrons at the Midwest Institute for Neutron Therapy at Fennilab. These patients were treated between January 1981 and March 1989. Four groups of patients were identified. Group I includes patients whose PSA values reached normal (0-4ng/ml) following neutron therapy and remained so subsequently. Of the fourteen patients in this group, twelve (86%) were disease free, with follow-up periods of 18 to 50 months. Only two of these fourteen patients were diagnosed with distant metastatic disease. A rapid fall of prostate specific antigen levels, with mean half life of 45 (±10) days, was observed in these patients. There were thirteen patients in Group II with PSA levels which remained elevated. Distant failure alone occurred in eight (62%) and as a component in two (15%) additional patients. Two of thirteen patients (15%) has local persistence of tumor. Only one patient in this group was free of disease at 1 year post treatment The mean half life of PSA in this group was 131 (±24) days. Group III consisted of nine patients with only an initial drop in the antigen levels. Of the nine, four ( 44 % ) were diagnosed with distant metastases and one of these failed locally as well. Three patients had local persistence of tumor. Two other patients had no clinical evidence of overt disease. ·Half life of the antigen was 94 (± 27) days. There were three patients in Group IV whose PSA levels slowly decreased although a normal baseline has not been achieved. They are all clinically well. Our preliminary observation is that the rapid normalization of PSA following neutron irradiation can be used to identify prostate cancer patients with good prognosis. However this observation needs confirmation in a larger series of patients followed for a longer period of time. Whether the early therapeutic intervention of hormonal manipulation for patients in Groups II, III, and IV is warranted and would alter their long term prognosis needs to be investigated.

• Research Organization: Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States)
• Sponsoring Organization: USDOE Office of Science (SC), High Energy Physics (HEP)
• DOE Contract Number: AC02-07CH11359
• OSTI ID: 1418792
• Report Number(s): FERMILAB-PUB-90-360-AD; 1651205
• Journal Information: Int.J.Radiat.Oncol.Biol.Phys., Vol. 19
• Country of Publication: United States
• Language: English