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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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).
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.
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).
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.
KeywordsAndrogen deprivation therapy Biochemical recurrence Prostate cancer Prostate-specific antigen Three-dimensional conformal radiotherapy
Compliance with ethical standards
Conflicts of interest
No author has any conflict of interest.
- 2.Matsuda T, Marugame T, Kamo KI et al (2010) Cancer incidence and incidence rates in Japan in 2004: based on data from 14 population-based cancer registries in the monitoring of cancer incidence in Japan (MCIJ) project. Jpn J Clin Oncol 40:1192–1200. https://doi.org/10.1093/jjco/hyq109 CrossRefPubMedGoogle Scholar
- 8.Cooperberg MR, Pasta DJ, Elkin EP et al (2005) The University of California, San Francisco cancer of the prostate risk assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol 173:1938–1942. https://doi.org/10.1097/01.ju.0000158155.33890.e7 CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Epstein JI, Allsbrook WCJ, Amin MB et al (2005) The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol 29:1228–1242. https://doi.org/10.1097/01.pas.0000173646.99337.b1 CrossRefPubMedGoogle Scholar
- 15.Bolla M, Van Tienhoven G, Warde P et al (2010) External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol 11:1066–1073. https://doi.org/10.1016/S1470-2045(10)70223-0 CrossRefPubMedGoogle Scholar
- 16.Horwitz EM, Bae K, Hanks GE et al (2008) Ten-year follow-up of radiation therapy oncology group protocol 92-02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol 26:2497–2504. https://doi.org/10.1200/JCO.2007.14.9021 CrossRefPubMedGoogle Scholar
- 19.Kupelian PA, Elshaikh M, Reddy CA et al (2002) Comparison of the efficacy of local therapies for localized prostate cancer in the prostate-specific antigen era: a large single-institution experience with radical prostatectomy and external-beam radiotherapy. J Clin Oncol 20:3376–3385. https://doi.org/10.1200/JCO.2002.01.150 CrossRefPubMedGoogle Scholar
- 21.D’Amico AV, Chen M-H, de Castro M et al (2012) Surrogate endpoints for prostate cancer-specific mortality after radiotherapy and androgen suppression therapy in men with localised or locally advanced prostate cancer: an analysis of two randomised trials. Lancet Oncol 13:189–195. https://doi.org/10.1016/S1470-2045(11)70295-9 CrossRefPubMedGoogle Scholar
- 24.Soto DE, Andridge RR, Pan CC et al (2008) In Patients Experiencing Biochemical Failure After Radiotherapy, Pretreatment Risk Group and PSA Velocity Predict Differences in Overall Survival and Biochemical Failure-Free Interval. Int J Radiat Oncol Biol Phys 71:1295–1301. https://doi.org/10.1016/j.ijrobp.2008.02.069 CrossRefPubMedGoogle Scholar