Int J Clin Oncol DOI 10.1007/s10147-014-0745-8
ORIGINAL ARTICLE
Clinical implications of a prostate‑specific antigen bounce after radiation therapy for prostate cancer Arash O. Naghavi · Tobin J. Strom · Kevin Nethers · Alex A. Cruz · Nicholas B. Figura · Kushagra Shrinath · Binglin Yue · Jongphil Kim · Matthew C. Biagioli · Daniel C. Fernandez · Randy V. Heysek · Richard B. Wilder
Received: 9 July 2014 / Accepted: 13 August 2014 © Japan Society of Clinical Oncology 2014
Abstract Background The objectives are to determine predictors of a prostate-specific antigen (PSA) bounce, whether a PSA bounce after radiotherapy for prostate cancer is associated with biochemical disease-free survival (bDFS), and the time course to a PSA bounce versus a biochemical failure post-irradiation. Methods Between July 2000 and December 2012, 691 prostate cancer patients without regional or distant metastases were treated with external beam radiation therapy and/ or brachytherapy, and had at least 12 months of follow-up. A PSA bounce was defined as a temporary PSA increase of ≥0.4 ng/mL. bDFS was defined according to the nadir + 2 definition. Results The median follow-up was 42 months. The median time to first PSA bounce was 17 months (95 % confidence interval 15–18 months). In contrast, the median time to biochemical failure was 41 months (95 % confidence interval 28–53 months). Two hundred and twenty-six of 691 (33 %) patients had at least one PSA bounce with a median magnitude of 1.0 ng/mL (range 0.4–17.0). A Gleason score of 6 (p 70 EBRT alone HDR brachytherapy alone
245 (60.0) 219 (77.7) 221 (60.2) 187 (72.5) 57 (86.4) 265 (62.2) 200 (75.5) 67 (75.3) 34 (69.4)
163 (40.0) 63 (22.3) 146 (39.8) 71 (27.5) 9 (13.6) 161 (37.8) 65 (24.5) 22 (24.7) 15 (30.6)
408 (59.1) 282 (40.9) 367 (53.1) 258 (37.3) 66 (9.6) 426 (61.6) 265 (38.4) 89 (12.9) 49 (7.1)
ORIGINAL ARTICLE
Clinical implications of a prostate‑specific antigen bounce after radiation therapy for prostate cancer Arash O. Naghavi · Tobin J. Strom · Kevin Nethers · Alex A. Cruz · Nicholas B. Figura · Kushagra Shrinath · Binglin Yue · Jongphil Kim · Matthew C. Biagioli · Daniel C. Fernandez · Randy V. Heysek · Richard B. Wilder
Received: 9 July 2014 / Accepted: 13 August 2014 © Japan Society of Clinical Oncology 2014
Abstract Background The objectives are to determine predictors of a prostate-specific antigen (PSA) bounce, whether a PSA bounce after radiotherapy for prostate cancer is associated with biochemical disease-free survival (bDFS), and the time course to a PSA bounce versus a biochemical failure post-irradiation. Methods Between July 2000 and December 2012, 691 prostate cancer patients without regional or distant metastases were treated with external beam radiation therapy and/ or brachytherapy, and had at least 12 months of follow-up. A PSA bounce was defined as a temporary PSA increase of ≥0.4 ng/mL. bDFS was defined according to the nadir + 2 definition. Results The median follow-up was 42 months. The median time to first PSA bounce was 17 months (95 % confidence interval 15–18 months). In contrast, the median time to biochemical failure was 41 months (95 % confidence interval 28–53 months). Two hundred and twenty-six of 691 (33 %) patients had at least one PSA bounce with a median magnitude of 1.0 ng/mL (range 0.4–17.0). A Gleason score of 6 (p 70 EBRT alone HDR brachytherapy alone
245 (60.0) 219 (77.7) 221 (60.2) 187 (72.5) 57 (86.4) 265 (62.2) 200 (75.5) 67 (75.3) 34 (69.4)
163 (40.0) 63 (22.3) 146 (39.8) 71 (27.5) 9 (13.6) 161 (37.8) 65 (24.5) 22 (24.7) 15 (30.6)
408 (59.1) 282 (40.9) 367 (53.1) 258 (37.3) 66 (9.6) 426 (61.6) 265 (38.4) 89 (12.9) 49 (7.1)
