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Title: Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer

Abstract

Purpose: To characterize the magnitude and kinetics of prostate-specific antigen (PSA) bounces after high-dose-rate (HDR) monotherapy and determine relationships between certain clinical factors and PSA bounce. Methods and Materials: Longitudinal PSA data and various clinical parameters were examined in 157 consecutive patients treated with HDR monotherapy between 1996 and 2005. We used the following definition for PSA bounce: rise in PSA ≥threshold, after which it returns to the prior level or lower. Prostate-specific antigen failure was defined per the Phoenix definition (nadir +2 ng/mL). Results: A PSA bounce was noted in 67 patients (43%). The number of bounces per patient was 1 in 45 cases (67%), 2 in 19 (28%), 3 in 2 (3%), 4 in 0, and 5 in 1 (1%). The median time to maximum PSA bounce was 1.3 years, its median magnitude was 0.7, and its median duration was 0.75 years. Three patients (2%) were noted to have PSA failure. None of the 3 patients who experienced biochemical failure exhibited PSA bounce. In the fully adjusted model for predicting each bounce, patients aged <55 years had a statistically significant higher likelihood of experiencing a bounce (odds ratio 2.22, 95% confidence interval 1.38-3.57, P=.001). There was also amore » statistically significant higher probability of experiencing a bounce for every unit decrease in Gleason score (odds ratio 1.52, 95% confidence interval 1.01-2.04, P=.045). Conclusions: A PSA bounce occurs in a significant percentage of patients treated with HDR monotherapy, with magnitudes varying from <1 in 28% of cases to ≥1 in 15%. The median duration of bounce is <1 year. More bounces were identified in patients with lower Gleason score and age <55 years. Further investigation using a model to correlate magnitude and frequency of bounces with clinical variables are under way.« less

Authors:
; ; ;  [1]
  1. University of California, Los Angeles, Los Angeles, California (United States)
Publication Date:
OSTI Identifier:
22224534
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 86; Journal Issue: 4; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANTIGENS; DOSE RATES; NEOPLASMS; PATIENTS; PROBABILITY; PROSTATE

Citation Formats

Mehta, Niraj H., E-mail: nmehta@mednet.ucla.edu, Kamrava, Mitchell, Wang, Pin-Chieh, Steinberg, Michael, and Demanes, Jeffrey. Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer. United States: N. p., 2013. Web. doi:10.1016/J.IJROBP.2013.02.032.
Mehta, Niraj H., E-mail: nmehta@mednet.ucla.edu, Kamrava, Mitchell, Wang, Pin-Chieh, Steinberg, Michael, & Demanes, Jeffrey. Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer. United States. https://doi.org/10.1016/J.IJROBP.2013.02.032
Mehta, Niraj H., E-mail: nmehta@mednet.ucla.edu, Kamrava, Mitchell, Wang, Pin-Chieh, Steinberg, Michael, and Demanes, Jeffrey. 2013. "Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer". United States. https://doi.org/10.1016/J.IJROBP.2013.02.032.
@article{osti_22224534,
title = {Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer},
author = {Mehta, Niraj H., E-mail: nmehta@mednet.ucla.edu and Kamrava, Mitchell and Wang, Pin-Chieh and Steinberg, Michael and Demanes, Jeffrey},
abstractNote = {Purpose: To characterize the magnitude and kinetics of prostate-specific antigen (PSA) bounces after high-dose-rate (HDR) monotherapy and determine relationships between certain clinical factors and PSA bounce. Methods and Materials: Longitudinal PSA data and various clinical parameters were examined in 157 consecutive patients treated with HDR monotherapy between 1996 and 2005. We used the following definition for PSA bounce: rise in PSA ≥threshold, after which it returns to the prior level or lower. Prostate-specific antigen failure was defined per the Phoenix definition (nadir +2 ng/mL). Results: A PSA bounce was noted in 67 patients (43%). The number of bounces per patient was 1 in 45 cases (67%), 2 in 19 (28%), 3 in 2 (3%), 4 in 0, and 5 in 1 (1%). The median time to maximum PSA bounce was 1.3 years, its median magnitude was 0.7, and its median duration was 0.75 years. Three patients (2%) were noted to have PSA failure. None of the 3 patients who experienced biochemical failure exhibited PSA bounce. In the fully adjusted model for predicting each bounce, patients aged <55 years had a statistically significant higher likelihood of experiencing a bounce (odds ratio 2.22, 95% confidence interval 1.38-3.57, P=.001). There was also a statistically significant higher probability of experiencing a bounce for every unit decrease in Gleason score (odds ratio 1.52, 95% confidence interval 1.01-2.04, P=.045). Conclusions: A PSA bounce occurs in a significant percentage of patients treated with HDR monotherapy, with magnitudes varying from <1 in 28% of cases to ≥1 in 15%. The median duration of bounce is <1 year. More bounces were identified in patients with lower Gleason score and age <55 years. Further investigation using a model to correlate magnitude and frequency of bounces with clinical variables are under way.},
doi = {10.1016/J.IJROBP.2013.02.032},
url = {https://www.osti.gov/biblio/22224534}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 86,
place = {United States},
year = {Mon Jul 15 00:00:00 EDT 2013},
month = {Mon Jul 15 00:00:00 EDT 2013}
}