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Significance of prostate-specific antigen kinetics after three-dimensional conformal radiotherapy with androgen deprivation therapy in patients with localized prostate cancer

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Abstract

Background

To evaluate the relationship between biochemical recurrence and post-radiation prostate-specific antigen (PSA) kinetics in patients with localized prostate cancer treated by radiotherapy with various durations of androgen deprivation therapy (ADT).

Methods

We reviewed our single-institution, retrospectively maintained data of 144 patients with T1c-T3N0M0 prostate cancer who underwent three-dimensional conformal radiotherapy (3D-CRT) between December 2005 and December 2015 and 113 patients were fulfilled the inclusion criteria. In this cohort, 3D-CRT was delivered with a dose in the range from 70.0 to 72.0 Gy with ADT. All patients received ADT as concurrent regimens. Biochemical recurrence was defined on the basis of the following: “PSA nadir + 2.0 ng/ml or the clinical judgement of attending physicians”. Kaplan–Meier, log-rank, and Cox regression analyses were carried out.

Results

The median follow-up period was 54.0 months. The median duration of ADT was 17 months (interquartile range, 10–24 months). There was a trend toward statistical significant correlation between post-radiation PSA decline rate of ≥ 90% and PSA recurrence (p = 0.056). The same correlation could be observed in D’Amico high-risk patients (p = 0.036). However, it was not observed between PSA nadir and PSA recurrence (p = 0.40) in univariate analysis. Furthermore, multivariate analysis showed that post-radiation PSA decline rate of ≥ 90% was a significant predictor of biochemical recurrence in patients who received radiotherapy with various durations of ADT (p = 0.044).

Conclusions

Post-radiation PSA decline rate of ≥ 90% was a prognostic factor for biochemical recurrence in localized prostate cancer patients received 3D-CRT with various durations of ADT.

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Authors and Affiliations

  1. Department of Urology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, 5-1 Tsukudocho, Shinjuku-ku, Tokyo, 162-8543, Japan

    Wataru Fukuokaya, Sangji Kim, Takao Natsuyama, Kanako Matsuzaki, Homare Shiomi, Hiroki Kitoh & Koichiro Akakura

  2. Department of Radiation Therapy, Community Health Care Organization Tokyo Shinjuku Medical Center Tokyo, Tokyo, Japan

    Nobuko Utsumi & Hiromasa Kurosaki

  3. Department of Pathology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan

    Masafumi Inoue

Authors
  1. Wataru Fukuokaya
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  2. Sangji Kim
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  3. Takao Natsuyama
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  4. Kanako Matsuzaki
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  5. Homare Shiomi
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  6. Hiroki Kitoh
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  7. Nobuko Utsumi
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  8. Hiromasa Kurosaki
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  9. Masafumi Inoue
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  10. Koichiro Akakura
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Corresponding author

Correspondence to Wataru Fukuokaya.

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Fukuokaya, W., Kim, S., Natsuyama, T. et al. Significance of prostate-specific antigen kinetics after three-dimensional conformal radiotherapy with androgen deprivation therapy in patients with localized prostate cancer. Int J Clin Oncol 23, 361–367 (2018). https://doi.org/10.1007/s10147-017-1216-9

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  • DOI: https://doi.org/10.1007/s10147-017-1216-9

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