BACKGROUND: The objectives are to determine predictors of a prostate-specific antigen (PSA) bounce, whether a PSA bounce after radiotherapy for prostate cancer is associated with biochemical disease-free survival (bDFS), and the time course to a PSA bounce versus a biochemical failure post-irradiation. METHODS: Between July 2000 and December 2012, 691 prostate cancer patients without regional or distant metastases were treated with external beam radiation therapy and/or brachytherapy, and had at least 12 months of follow-up. A PSA bounce was defined as a temporary PSA increase of ≥ 0.4 ng/mL. bDFS was defined according to the nadir + 2 definition. RESULTS: The median follow-up was 42 months. The median time to first PSA bounce was 17 months (95% confidence interval 15-18 months). In contrast, the median time to biochemical failure was 41 months (95% confidence interval 28-53 months). Two hundred and twenty-six of 691 (33%) patients had at least one PSA bounce with a median magnitude of 1.0 ng/mL (range 0.4-17.0). A Gleason score of 6 (p < 0.0001) predicted a PSA bounce on multivariate analysis. Patients with a PSA bounce experienced improved bDFS on multivariate analysis (p = 0.002). CONCLUSIONS: Patients with a Gleason score of 6 were more likely to experience a PSA bounce which was associated with improved bDFS. A PSA bounce occurred sooner after radiotherapy than a biochemical failure. The authors recommend against performing prostate biopsies within 24-30 months of radiotherapy since an elevated PSA may simply represent a benign PSA bounce.
BACKGROUND: The objectives are to determine predictors of a prostate-specific antigen (PSA) bounce, whether a PSA bounce after radiotherapy for prostate cancer is associated with biochemical disease-free survival (bDFS), and the time course to a PSA bounce versus a biochemical failure post-irradiation. METHODS: Between July 2000 and December 2012, 691 prostate cancerpatients without regional or distant metastases were treated with external beam radiation therapy and/or brachytherapy, and had at least 12 months of follow-up. A PSA bounce was defined as a temporary PSA increase of ≥ 0.4 ng/mL. bDFS was defined according to the nadir + 2 definition. RESULTS: The median follow-up was 42 months. The median time to first PSA bounce was 17 months (95% confidence interval 15-18 months). In contrast, the median time to biochemical failure was 41 months (95% confidence interval 28-53 months). Two hundred and twenty-six of 691 (33%) patients had at least one PSA bounce with a median magnitude of 1.0 ng/mL (range 0.4-17.0). A Gleason score of 6 (p < 0.0001) predicted a PSA bounce on multivariate analysis. Patients with a PSA bounce experienced improved bDFS on multivariate analysis (p = 0.002). CONCLUSIONS:Patients with a Gleason score of 6 were more likely to experience a PSA bounce which was associated with improved bDFS. A PSA bounce occurred sooner after radiotherapy than a biochemical failure. The authors recommend against performing prostate biopsies within 24-30 months of radiotherapy since an elevated PSA may simply represent a benign PSA bounce.
Authors: Eric M Horwitz; Lawrence B Levy; Howard D Thames; Patrick A Kupelian; Alvaro A Martinez; Jeffrey M Michalski; Thomas M Pisansky; Howard M Sandler; William U Shipley; Michael J Zelefsky; Anthony L Zietman; Deborah A Kuban Journal: Cancer Date: 2006-10-01 Impact factor: 6.860
Authors: R Shaffer; W J Morris; V Moiseenko; M Welsh; C Crumley; S Nakano; M Schmuland; T Pickles; K Otto Journal: Clin Oncol (R Coll Radiol) Date: 2009-03-05 Impact factor: 4.126
Authors: Brian J Davis; Eric M Horwitz; W Robert Lee; Juanita M Crook; Richard G Stock; Gregory S Merrick; Wayne M Butler; Peter D Grimm; Nelson N Stone; Louis Potters; Anthony L Zietman; Michael J Zelefsky Journal: Brachytherapy Date: 2012 Jan-Feb Impact factor: 2.362
Authors: Prajnan Das; Ming-H Chen; Kristin Valentine; Lynn Lopes; Robert A Cormack; Andrew A Renshaw; Clare M Tempany; Sanjaya Kumar; Anthony V D'Amico Journal: Int J Radiat Oncol Biol Phys Date: 2002-11-01 Impact factor: 7.038
Authors: Katherine O Castle; Karen E Hoffman; Lawrence B Levy; Andrew K Lee; Seungtaek Choi; Quynh N Nguyen; Steven J Frank; Thomas J Pugh; Sean E McGuire; Deborah A Kuban Journal: Int J Radiat Oncol Biol Phys Date: 2012-07-24 Impact factor: 7.038
Authors: Nicholas G Zaorsky; Brian J Davis; Paul L Nguyen; Timothy N Showalter; Peter J Hoskin; Yasuo Yoshioka; Gerard C Morton; Eric M Horwitz Journal: Nat Rev Urol Date: 2017-06-30 Impact factor: 14.432