Prostate-specific antigen kinetics after I125-brachytherapy for prostate adenocarcinoma
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- 作者：Alessia Guarneri (1)
Angela Botticella (1)
Riccardo Ragona (1)
Andrea Riccardo Filippi (1)
Fernando Munoz (1)
Giovanni Casetta (2)
Paolo Gontero (2)
Alessandro Tizzani (2)
Umberto Ricardi (1) - 关键词：Brachytherapy ; Prostate adenocarcinoma ; Prostate ; specific antigen (PSA) bounce ; Prostate ; specific antigen (PSA) nadir
- 刊名：World Journal of Urology
- 出版年：2013
- 出版时间：April 2013
- 年：2013
- 卷：31
- 期：2
- 页码：411-415
- 全文大小：171KB
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8. Grimm PD, Blasko JC, Sylvester JE, Meier RM, Cavanagh W (2001) 10-year biochemical (prostate-specific antigen) control of prostate cancer with (125)I brachytherapy. Int J Radiat Oncol Biol Phys 51:31-0. doi:10.1016/S0360-3016(01)01601-7 CrossRef
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10. Patel C, Elshaikh MA, Angermeier K et al (2004) PSA bounce predicts early success in patients with permanent iodine-125 prostate implant. Urology 63:110-13. doi:10.1016/j.urology.2003.08.025 CrossRef
11. Stock RG, Stone NN, Cesaretti JA (2003) Prostate-specific antigen bounce after prostate seed implantation for localized prostate cancer: descriptions and implications. Int J Radiat Oncol Biol Phys 56:448-53. doi:10.1016/S0360-3016(02)04470-X CrossRef
12. Critz FA, Williams WH, Levinson AK et al (2003) Prostate specific antigen bounce after simultaneous irradiation for prostate cancer: the relationship to patient age. J Urol 170:1864-867. doi:10.1097/01.ju.0000091644.41330.2a CrossRef
13. Satoh T, Ishiyama H, Matsumoto K et al (2009) Prostate-specific antigen ‘bounce-after permanent 125I-implant brachytherapy in Japanese men: a multi-institutional pooled analysis. BJU Int 103:1064-068. doi:10.1111/j.1464-410X.2008.08234.x CrossRef
14. Zwahlen DR, Smith R, Andrianopoulos N, Matheson B, Royce P, Millar JL (2011) Prostate-specific antigen bounce after permanent iodine-125 prostate brachytherapy—an Australian analysis. Int J Radiat Oncol Biol Phys 79:179-87. doi:10.1016/j.ijrobp.2009.10.016 CrossRef
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16. Frank SJ, Levy LB, van Vulpen M et al (2012) Outcomes after prostate brachytherapy are even better than predicted. Cancer 118:839-47. doi:10.1002/cncr.26307 CrossRef - 作者单位：Alessia Guarneri (1)
Angela Botticella (1)
Riccardo Ragona (1)
Andrea Riccardo Filippi (1)
Fernando Munoz (1)
Giovanni Casetta (2)
Paolo Gontero (2)
Alessandro Tizzani (2)
Umberto Ricardi (1)
1. Radiation Oncology, Department of Medical and Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy
2. Urology, Department of Medical and Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy - ISSN：1433-8726
文摘
Purpose To investigate a potential correlation between the achievement of a cut-off of nadir PSA (nPSA) after brachytherapy (BRT) with biochemical Disease-Free Survival (bDFS) and to define the rate of post-BRT PSA bounces. Methods Retrospective analysis was carried out in 105 consecutive patients affected with early-stage prostate adenocarcinoma who underwent 125I BRT. Only patients with a minimum follow-up ?4?months were included. Biochemical DFS was chosen as primary endpoint. Results At a median follow-up of 51.2?months, 3- and 5-year bDFS were 96.8 and 91.2?%, respectively. Median time to biochemical failure (BF) was 54?months. By Kaplan–Meier analysis, patients achieving nPSA?≤?.35?ng/mL had significantly higher bDFS (3- and 5-year bDFS: 100 and 98.5?% vs 83.3 and 66.7?%, respectively; p?=?0.001). Bounce PSA occurred in 28.6?% of patients, at a median time of 21.5?months. No BFs were observed in the bounce group. Achieving a nPSA?≤?.35?ng/mL was the only factor independently associated with long-term bDFS on both univariate (p?=?0.000) and multivariate analysis (HR 3.82; p?=?0.003). Conclusions Patients attaining a nPSA?≤?.35?ng/mL are significantly more likely to experience long-term freedom-from-biochemical failure. Bounce PSA occurs in approximately 30?% of patients. Time to onset of PSA increase seems the most reliable feature to distinguish bounce from failure. Tailored follow-up strategies are needed for patients at higher risk of recurrence, and caution is advised in interpreting an early increase in PSA levels in the first 24-0?months after BRT.