Journal article
PSA bounce after ¹²⁵I-brachytherapy for prostate cancer as a favorable prognosticator.
- Engeler DS Department of Urology, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland. daniel.engeler@kssg.ch.
- Schwab C Department of Urology, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland.
- Thöni AF Department of Radiation Oncology, Lindenhofspital Berne, Berne, Switzerland.
- Hochreiter W Department of Urology, Hirslanden Klinik Aarau, Aarau, Switzerland.
- Prikler L Department of Urology, Klinik Uroviva Bülach, Bülach, Switzerland.
- Suter S Department of Urology, Cantonal Hospital Zug, Zug, Switzerland.
- Stucki P Department of Urology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
- Schiefer J Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Plasswilm L Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- Schmid HP Department of Urology, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland.
- Putora PM Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
- 2015-06-24
Published in:
- Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. - 2015
Biochemical relapse
Brachytherapy
PSA bounce
Prognosis
Prostate cancer
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
Brachytherapy
Combined Modality Therapy
Follow-Up Studies
Humans
Iodine Radioisotopes
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Recurrence, Local
Prognosis
Prospective Studies
Prostate-Specific Antigen
Prostatic Neoplasms
Switzerland
English
BACKGROUND
Permanent low-dose-rate brachytherapy (BT) with iodine 125 is an established curative treatment for localized prostate cancer. After treatment, prostate-specific antigen (PSA) kinetics may show a transient rise (PSA bounce). Our aim was to investigate the association of PSA bounce with biochemical control.
PATIENTS AND METHODS
Patients treated with BT in Switzerland were registered in a prospective database. Only patients with a follow-up of at least 2 years were included in our analysis. Clinical follow-up and PSA measurements were assessed after 1.5, 3, 6, and 12 months, and annually thereafter. If PSA increased, additional follow-up visits were scheduled. Cases of PSA bounce were defined as a rise of at least 0.2 ng/ml above the initial PSA nadir with a subsequent decline to or below the initial nadir without treatment. Biochemical failure was defined as a rise to nadir + 2 ng/ml.
RESULTS
Between March 2001 and November 2010, 713 patients with prostate cancer undergoing BT with at least 2 years of follow-up were registered. Median follow-up time was 41 months. Biochemical failure occurred in 28 patients (3.9 %). PSA bounce occurred in 173 (24.3 %) patients; only three (1.7 %) patients with PSA bounce developed biochemical failure, in contrast to 25 (4.6 %) patients without previous bounce (p < 0.05). The median time to bounce was 12 months, the median time to biochemical failure was 30 months. The median bounce increase was 0.78 ng/ml. Twenty-eight patients with bounce (16.5 %) had a transient PSA rise of + 2 ng/ml above the nadir.
CONCLUSION
In most cases, an early increase in PSA after BT indicates PSA bounce and is associated with a lower risk of biochemical failure.
Permanent low-dose-rate brachytherapy (BT) with iodine 125 is an established curative treatment for localized prostate cancer. After treatment, prostate-specific antigen (PSA) kinetics may show a transient rise (PSA bounce). Our aim was to investigate the association of PSA bounce with biochemical control.
PATIENTS AND METHODS
Patients treated with BT in Switzerland were registered in a prospective database. Only patients with a follow-up of at least 2 years were included in our analysis. Clinical follow-up and PSA measurements were assessed after 1.5, 3, 6, and 12 months, and annually thereafter. If PSA increased, additional follow-up visits were scheduled. Cases of PSA bounce were defined as a rise of at least 0.2 ng/ml above the initial PSA nadir with a subsequent decline to or below the initial nadir without treatment. Biochemical failure was defined as a rise to nadir + 2 ng/ml.
RESULTS
Between March 2001 and November 2010, 713 patients with prostate cancer undergoing BT with at least 2 years of follow-up were registered. Median follow-up time was 41 months. Biochemical failure occurred in 28 patients (3.9 %). PSA bounce occurred in 173 (24.3 %) patients; only three (1.7 %) patients with PSA bounce developed biochemical failure, in contrast to 25 (4.6 %) patients without previous bounce (p < 0.05). The median time to bounce was 12 months, the median time to biochemical failure was 30 months. The median bounce increase was 0.78 ng/ml. Twenty-eight patients with bounce (16.5 %) had a transient PSA rise of + 2 ng/ml above the nadir.
CONCLUSION
In most cases, an early increase in PSA after BT indicates PSA bounce and is associated with a lower risk of biochemical failure.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00066-015-0860-0
- PMID 26100965
- Persistent URL
- https://sonar.ch/global/documents/186453
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