Prostate Specific Antigen Bounce Is Related to Overall Survival in Prostate Brachytherapy
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht (Netherlands)
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands)
- Department of Radiation Oncology, M. D. Anderson Cancer Center, Houston, TX (United States)
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 {sup 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.
- OSTI ID:
- 22056053
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 82, Issue 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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