OBJECTIVES: To determine whether nadir prostate-specific antigen (PSA) levels within 12 months (nadir PSA12) after completion of radiotherapy (RT) can be used as an early marker of recurrence risk. METHODS: A total of 4839 patients were treated with RT and without hormonal therapy from 1986 to 1995 for Stage T1-T2 prostate cancer at nine institutions. Of these 4839 patients, 4833, with a median follow-up of 6.3 years, met the criteria for analysis. The study endpoints included freedom from PSA failure, initiation of androgen deprivation, or documented local or distant failure (PSA-DFS); freedom from clinically apparent distant metastasis (DMFS); and overall survival (OS). RESULTS: Patients with a nadir PSA12 of 2.0 ng/mL or less had an 8-year PSA-DFS, DMFS, and OS rate of 55%, 95%, and 73%, respectively, compared with 40%, 88%, and 69%, respectively, for patients with a nadir PSA12 of more than 2.0 ng/mL. Multivariate analysis confirmed that a nadir PSA12 of greater than 2 ng/mL was an independent predictor of PSA-DFS, DMFS, and OS. Classification and regression tree analysis identified the nadir PSA12 levels after RT associated with PSA-DFS, DMFS, and OS. Nadir PSA12, combined with the pretreatment PSA level, identified patients at particularly high risk of distant metastasis. CONCLUSIONS: The results of this large, multi-institutional study have demonstrated that nadir PSA12 is predictive of clinical outcomes for patients with localized prostate cancer after RT. A high pretreatment PSA level and high nadir PSA12 will identify patients at particularly high risk who might benefit from early adjuvant therapy.
OBJECTIVES: To determine whether nadir prostate-specific antigen (PSA) levels within 12 months (nadir PSA12) after completion of radiotherapy (RT) can be used as an early marker of recurrence risk. METHODS: A total of 4839 patients were treated with RT and without hormonal therapy from 1986 to 1995 for Stage T1-T2 prostate cancer at nine institutions. Of these 4839 patients, 4833, with a median follow-up of 6.3 years, met the criteria for analysis. The study endpoints included freedom from PSA failure, initiation of androgen deprivation, or documented local or distant failure (PSA-DFS); freedom from clinically apparent distant metastasis (DMFS); and overall survival (OS). RESULTS:Patients with a nadir PSA12 of 2.0 ng/mL or less had an 8-year PSA-DFS, DMFS, and OS rate of 55%, 95%, and 73%, respectively, compared with 40%, 88%, and 69%, respectively, for patients with a nadir PSA12 of more than 2.0 ng/mL. Multivariate analysis confirmed that a nadir PSA12 of greater than 2 ng/mL was an independent predictor of PSA-DFS, DMFS, and OS. Classification and regression tree analysis identified the nadir PSA12 levels after RT associated with PSA-DFS, DMFS, and OS. Nadir PSA12, combined with the pretreatment PSA level, identified patients at particularly high risk of distant metastasis. CONCLUSIONS: The results of this large, multi-institutional study have demonstrated that nadir PSA12 is predictive of clinical outcomes for patients with localized prostate cancer after RT. A high pretreatment PSA level and high nadir PSA12 will identify patients at particularly high risk who might benefit from early adjuvant therapy.
Authors: Rebecca G Levin-Epstein; Naomi Y Jiang; Xiaoyan Wang; Shrinivasa K Upadhyaya; Sean P Collins; Simeng Suy; Nima Aghdam; Constantine Mantz; Alan J Katz; Leszek Miszczyk; Aleksandra Napieralska; Agnieszka Namysl-Kaletka; Nicholas Prionas; Hilary Bagshaw; Mark K Buyyounouski; Minsong Cao; Nzhde Agazaryan; Audrey Dang; Ye Yuan; Patrick A Kupelian; Nicholas G Zaorsky; Daniel E Spratt; Osama Mohamad; Felix Y Feng; Brandon A Mahal; Paul C Boutros; Arun U Kishan; Jesus Juarez; David Shabsovich; Tommy Jiang; Sartajdeep Kahlon; Ankur Patel; Jay Patel; Nicholas G Nickols; Michael L Steinberg; Donald B Fuller; Amar U Kishan Journal: Radiother Oncol Date: 2020-10-07 Impact factor: 6.280
Authors: Christopher L Hallemeier; Peixin Zhang; Thomas M Pisansky; Gerald E Hanks; David G McGowan; Mack Roach; Kenneth L Zeitzer; Selim Y Firat; Siraj M Husain; David P D'Souza; Luis Souhami; Matthew B Parliament; Seth A Rosenthal; Himanshu R Lukka; Marvin Rotman; Eric M Horwitz; Edward F Miles; Rebecca Paulus; Howard M Sandler Journal: Int J Radiat Oncol Biol Phys Date: 2019-04-06 Impact factor: 7.038
Authors: Andrew W Ju; Hongkun Wang; Eric K Oermann; Benjamin A Sherer; Sunghae Uhm; Viola J Chen; Arjun V Pendharkar; Heather N Hanscom; Joy S Kim; Siyuan Lei; Simeng Suy; John H Lynch; Anatoly Dritschilo; Sean P Collins Journal: Radiat Oncol Date: 2013-01-31 Impact factor: 3.481
Authors: David Pasquier; Philippe Nickers; Didier Peiffert; Philippe Maingon; Pascal Pommier; Thomas Lacornerie; Geoffrey Martinage; Emmanuelle Tresch; Eric Lartigau Journal: PLoS One Date: 2017-11-30 Impact factor: 3.240