Marcus Foo1, Mariel Lavieri, Tom Pickles. 1. Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. Marcus.Foo@petermac.org
Abstract
PURPOSE: To confirm findings from an earlier report showing that neoadjuvant (NA) prostate-specific antigen (PSA) halving time (PSAHT) impacts biochemical failure (BF) rates, and to examine its association with prostate cancer-specific survival (PCSS), in a large prospective cohort of patients. METHODS AND MATERIALS: A total of 502 patients were selected from a prospective database, who had localized prostate adenocarcinoma treated with 2-12 months of neoadjuvant androgen deprivation therapy (N-ADT) followed by external beam radiation therapy (EBRT) between 1994 and 2000, and had at least 2 NA PSA values. Seventy-four percent of patients had high-risk prostate cancer. Median initial PSA value, N-ADT duration, total ADT duration, and radiation therapy dose were 14 ng/mL, 6.9 months, 10.8 months, and 68 Gy, respectively. RESULTS: At a median follow-up of 9.9 years, 210 patients have had a BF. Median PSAHT was 18 days. On univariate analysis, PSAHT was not shown to predict for BF (P=.69) or PCSS (P=.28). However, NA nadir PSA (nanPSA) and post-therapy nadir PSA (ptnPSA), when analyzed as continuous or categoric variables, predicted for BF (P<.001) and PCSS (P<.001). On multivariate analysis, nanPSA (P=.037) and ptnPSA (P<.001) continued to be significantly associated with BF. However, N-ADT duration lost significance (P=.67), and PSAHT remained a nonsignificant predictor (P=.97). For PCSS, multivariate analysis showed nanPSA (P=.049) and ptnPSA (P<.001) to be significant. Again PSAHT (P=.49) remained nonsignificant. CONCLUSIONS: In this large, prospective cohort of patients, NA PSA kinetics, expressed as PSAHT, did not predict BF or PCSS. However, nadir PSAs, in both the NA and post-therapy settings, were significant predictors of BF and PCSS. Optimization of therapy could potentially be based on early PSA response, with shorter durations of ADT for those predicted to do favorably, and intensification of therapy for those likely to have poorer outcomes.
PURPOSE: To confirm findings from an earlier report showing that neoadjuvant (NA) prostate-specific antigen (PSA) halving time (PSAHT) impacts biochemical failure (BF) rates, and to examine its association with prostate cancer-specific survival (PCSS), in a large prospective cohort of patients. METHODS AND MATERIALS: A total of 502 patients were selected from a prospective database, who had localized prostate adenocarcinoma treated with 2-12 months of neoadjuvant androgen deprivation therapy (N-ADT) followed by external beam radiation therapy (EBRT) between 1994 and 2000, and had at least 2 NA PSA values. Seventy-four percent of patients had high-risk prostate cancer. Median initial PSA value, N-ADT duration, total ADT duration, and radiation therapy dose were 14 ng/mL, 6.9 months, 10.8 months, and 68 Gy, respectively. RESULTS: At a median follow-up of 9.9 years, 210 patients have had a BF. Median PSAHT was 18 days. On univariate analysis, PSAHT was not shown to predict for BF (P=.69) or PCSS (P=.28). However, NA nadir PSA (nanPSA) and post-therapy nadir PSA (ptnPSA), when analyzed as continuous or categoric variables, predicted for BF (P<.001) and PCSS (P<.001). On multivariate analysis, nanPSA (P=.037) and ptnPSA (P<.001) continued to be significantly associated with BF. However, N-ADT duration lost significance (P=.67), and PSAHT remained a nonsignificant predictor (P=.97). For PCSS, multivariate analysis showed nanPSA (P=.049) and ptnPSA (P<.001) to be significant. Again PSAHT (P=.49) remained nonsignificant. CONCLUSIONS: In this large, prospective cohort of patients, NA PSA kinetics, expressed as PSAHT, did not predict BF or PCSS. However, nadir PSAs, in both the NA and post-therapy settings, were significant predictors of BF and PCSS. Optimization of therapy could potentially be based on early PSA response, with shorter durations of ADT for those predicted to do favorably, and intensification of therapy for those likely to have poorer outcomes.
Authors: Mira A Patel; Marisa Kollmeier; Sean McBride; Daniel Gorovets; Melissa Varghese; Luanna Chan; Andrea Knezevic; Zhigang Zhang; Michael J Zelefsky Journal: Radiother Oncol Date: 2019-06-06 Impact factor: 6.280
Authors: Christopher Sweeney; Mari Nakabayashi; Meredith Regan; Wanling Xie; Julia Hayes; Nancy Keating; Suhui Li; Tomas Philipson; Marc Buyse; Susan Halabi; Philip Kantoff; A Oliver Sartor; Howard Soule; Brandon Mahal Journal: J Natl Cancer Inst Date: 2015-09-25 Impact factor: 13.506
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: A K Narang; J Trieu; N Radwan; A Ram; S P Robertson; P He; C Gergis; E Griffith; H Singh; T A DeWeese; S Honig; A Annadanam; S Greco; C DeVille; T McNutt; T L DeWeese; D Y Song; P T Tran Journal: Prostate Cancer Prostatic Dis Date: 2017-01-17 Impact factor: 5.554
Authors: Fady B Geara; Muhammad Bulbul; Raja B Khauli; Therese Y Andraos; Mirna Abboud; Abdelatif Al Mousa; Nasim Sarhan; Ahmed Salem; Hamza Ghatasheh; Anoud Alnsour; Zeina Ayoub; Ibrahim Abu Gheida; Maya Charafeddine; Mohammed Shahait; Ali Shamseddine; Rami Abu Gheida; Jamal Khader Journal: Radiat Oncol Date: 2017-09-07 Impact factor: 3.481