Article (Scientific journals)
Prognostic value of PSA nadir < or =4 ng/ml within 4 months of high-dose radiotherapy for locally advanced prostate cancer
Nickers, Philippe; Albert, Adelin; Waltregny, David et al.
2006In International Journal of Radiation, Oncology, Biology, Physics, 65 (1), p. 73-77
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Keywords :
prostate; PSA; kinetics; nadir; radiotherapy
Abstract :
[en] PURPOSE: To investigate early prostate-specific antigen (PSA) kinetics after high radiation doses of 85 Gy on locally advanced prostate cancer. METHODS AND MATERIALS: A total of 201 patients were prospectively and consecutively treated with external beam radiotherapy and a brachytherapy boost. Of the 201 patients, 104 received concomitant hormonal therapy on the decision of the referring urologist and were excluded, yielding a study population of 97 patients. The first posttreatment PSA analysis was performed not earlier than 1 month after treatment completion but within the first 4 months, and then every 4 months. Analysis of PSA kinetics included the PSA nadir (nPSA) at values of < or =4 ng/mL to < or =0.5 ng/mL. The nPSA at < or =4 ng/mL within 4 months (nPSA < or =4/4m) was the variable of interest. RESULTS: We established highly significant associations between an nPSA of < or =1 and < or =0.5 ng/mL and the nPSA < or =4/4m (p <0.0001). A hazard ratio of 0.33 (95% Confidence Interval (CI), 0.12-0.91) underlined the lower risk of recurrence related to nPSA < or =4/4m achievement (p = 0.033). Using time-dependent covariate models for patients who did not reach an nPSA < or =4/4m, an nPSA of < or =1 ng/mL remained without prognostic significance (p = 0.06). However, for patients who reached an nPSA < or =4/4m, an nPSA of < or =1 ng/mL did significantly improve the prognosis (p <0.001), but much later after treatment. The same analysis was repeated for nPSA < or =0.5 ng/mL with similar conclusions as when nPSA < or =4/4m was obtained (p <0.01). CONCLUSION: The nPSA < or =4/4m has been demonstrated to be a significant predictor of biochemical no evidence of disease after high radiation doses of 85 Gy. Its major advantage is that it was available earlier than the other nadirs.
Disciplines :
Oncology
Radiology, nuclear medicine & imaging
Author, co-author :
Nickers, Philippe ;  Université de Liège - ULiège > Département des sciences cliniques
Albert, Adelin  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique
Waltregny, David  ;  Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Labo de recherche sur les métastases
Deneufbourg, Jean-Marie  ;  Université de Liège - ULiège > Département des sciences cliniques > Radiothérapie
Language :
English
Title :
Prognostic value of PSA nadir < or =4 ng/ml within 4 months of high-dose radiotherapy for locally advanced prostate cancer
Publication date :
01 May 2006
Journal title :
International Journal of Radiation, Oncology, Biology, Physics
ISSN :
0360-3016
eISSN :
1879-355X
Publisher :
Elsevier Science Inc, New York, United States - New York
Volume :
65
Issue :
1
Pages :
73-77
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 25 January 2009

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