PURPOSE: To report the incidence, timing, and magnitude of the benign prostate-specific antigen (PSA) bounce after 125I prostate brachytherapy and correlate the bounce with clinical and/or dosimetric factors. METHODS AND MATERIALS: From March 1999 to August 2003, a total of 292 men received 125I prostate brachytherapy without androgen deprivation or supplemental beam radiotherapy and have PSA follow-up >30 months. Implants were preplanned using transrectal ultrasound (TRUS) and performed under transrectal ultrasound/fluoroscopy guidance using preloaded needles. A PSA bounce is defined as an increase >or=0.2 ng/ml with spontaneous return to prebounce level or lower. RESULTS: Resolved PSA bounces were seen in 40% of men with follow-up >30 months. Median onset was 15 months, and median magnitude was 0.76 ng/ml. Magnitude >2 ng/ml was seen in 15%. The only clinical or dosimetric factor predictive of bounce in multivariate analysis was younger age. Median time to increasing PSA level indicative of failure was 30 months. CONCLUSIONS: Benign PSA bounces are common after 125I prostate brachytherapy, especially in younger men. An increase >2 ng/ml above the nadir was seen in 15%. Magnitude of increase does not distinguish bounce from failure. Time to the start of the PSA increase can be helpful, but is not absolute. The PSA bounce does not predict subsequent failure. Caution is advised in interpreting an early increasing PSA level in the first 30 months after 125I brachytherapy in favorable-risk patients.
PURPOSE: To report the incidence, timing, and magnitude of the benign prostate-specific antigen (PSA) bounce after 125I prostate brachytherapy and correlate the bounce with clinical and/or dosimetric factors. METHODS AND MATERIALS: From March 1999 to August 2003, a total of 292 men received 125I prostate brachytherapy without androgen deprivation or supplemental beam radiotherapy and have PSA follow-up >30 months. Implants were preplanned using transrectal ultrasound (TRUS) and performed under transrectal ultrasound/fluoroscopy guidance using preloaded needles. A PSA bounce is defined as an increase >or=0.2 ng/ml with spontaneous return to prebounce level or lower. RESULTS: Resolved PSA bounces were seen in 40% of men with follow-up >30 months. Median onset was 15 months, and median magnitude was 0.76 ng/ml. Magnitude >2 ng/ml was seen in 15%. The only clinical or dosimetric factor predictive of bounce in multivariate analysis was younger age. Median time to increasing PSA level indicative of failure was 30 months. CONCLUSIONS: Benign PSA bounces are common after 125I prostate brachytherapy, especially in younger men. An increase >2 ng/ml above the nadir was seen in 15%. Magnitude of increase does not distinguish bounce from failure. Time to the start of the PSA increase can be helpful, but is not absolute. The PSA bounce does not predict subsequent failure. Caution is advised in interpreting an early increasing PSA level in the first 30 months after 125I brachytherapy in favorable-risk patients.
Authors: Daniel S Engeler; Christoph Schwab; Armin F Thöni; Werner Hochreiter; Ladislav Prikler; Stefan Suter; Patrick Stucki; Johann Schiefer; Ludwig Plasswilm; Hans-Peter Schmid; Paul Martin Putora Journal: Strahlenther Onkol Date: 2015-06-23 Impact factor: 3.621
Authors: Juanita M Crook; Chad Tang; Howard Thames; Pierre Blanchard; Jeremiah Sanders; Jay Ciezki; Mira Keyes; W James Morris; Gregory Merrick; Charles Catton; Hamid Raziee; Richard Stock; Frank Sullivan; Mitch Anscher; Jeremy Millar; Steven Frank Journal: Radiother Oncol Date: 2020-04-27 Impact factor: 6.280
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: Leonard N Chen; Simeng Suy; Sunghae Uhm; Eric K Oermann; Andrew W Ju; Viola Chen; Heather N Hanscom; Sarah Laing; Joy S Kim; Siyuan Lei; Gerald P Batipps; Keith Kowalczyk; Gaurav Bandi; John Pahira; Kevin G McGeagh; Brian T Collins; Pranay Krishnan; Nancy A Dawson; Kathryn L Taylor; Anatoly Dritschilo; John H Lynch; Sean P Collins Journal: Radiat Oncol Date: 2013-03-13 Impact factor: 3.481