A zero PSA slope in posttreatment prostate-specific antigen supports cure of patients with long-term follow-up after external beam radiotherapy for localized prostate cancer

Takamiya, Robert; Weinberg, Vivian; Young, Charlie; Sandler, Howard M.; McLaughlin, Peter; Roach, Mack

doi:10.1016/s0360-3016(03)00206-2

Cited by 23 publications

(12 citation statements)

References 11 publications

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“…It may take several years, though, before a PSA nadir is reached following radiotherapy [88,89]. During this period, nearly one third of patients will experience at least one PSA bounce of 0.3-3.4 ng/ml; about half of these patients do not have recurrent cancer [90,91].…”

Section: Treatment Monitoringmentioning

confidence: 99%

Dynamic contrast-enhanced magnetic resonance imaging and pharmacokinetic models in prostate cancer

2010

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Dynamic contrast-enhanced MRI enables noninvasive analysis of prostate vascularization as well as tumour angiogenesis and capillary permeability characteristics in prostate cancers. Pharmacokinetic models summarizing the complex information provided by signal intensity-time curves for a few quantitative pharmacokinetic parameters are increasingly being used in the routine clinical setting. This review consists of two parts. The first part discusses the advantages and disadvantages of the MR pulse sequences that can be used for performing DCE-MRI and also of the most widely used pharmacokinetic parameters and models and the parameters they describe. The second part outlines the range of current and potential future clinical applications of DCE-MRI and pharmacokinetic parametric maps in patients with prostate cancer, with reference to the current scientific literature on the topic. The potential clinical applications of DCE-MRI for prostate cancer include detection, localization, and staging, differentiation of recurrent cancer and estimation of the patient's prognosis, as well as monitoring of treatment response.

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Section: Treatment Monitoringmentioning

confidence: 99%

Dynamic contrast-enhanced magnetic resonance imaging and pharmacokinetic models in prostate cancer

2010

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“…Specifically, a lower PSA nadir (< 0.5 ng/ml) has been associated with increased freedom from biochemical failure [29][30][31][32]. While increasing PSA values can either indicate biochemical failure [33] or PSA bounce [34], continued decline or stability in PSA is linked with biochemical control [35,36]. The interpretation of the PSA rate of decline following radiotherapy, as measured by the PSA slope, is more controversial.…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated SBRT Versus Conventionally Fractionated EBRT for Prostate Cancer: Comparison of PSA Slope and Nadir

Anwar

Weinberg

Chang

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

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Background: Patients with early stage prostate cancer have a variety of curative radiotherapy options, including conventionally-fractionated external beam radiotherapy (CF-EBRT) and hypofractionated stereotactic body radiotherapy (SBRT). Although results of CF-EBRT are well known, the use of SBRT for prostate cancer is a more recent development, and long-term follow-up is not yet available. However, rapid post-treatment PSA decline and low PSA nadir have been linked to improved clinical outcomes. The purpose of this study was to compare the PSA kinetics between CF-EBRT and SBRT in newly diagnosed localized prostate cancer. Materials/methods: 75 patients with low to low-intermediate risk prostate cancer (T1-T2; GS 3 + 3, PSA < 20 or 3 + 4, PSA < 15) treated without hormones with CF-EBRT (>70.2 Gy, <76 Gy) to the prostate only, were identified from a prospectively collected cohort of patients treated at the University of California, San Francisco (1997. Patients were excluded if they failed therapy by the Phoenix definition or had less than 1 year of follow-up or <3 PSAs. 43 patients who were treated with SBRT to the prostate to 38 Gy in 4 daily fractions also met the same criteria. PSA nadir and rate of change in PSA over time (slope) were calculated from the completion of RT to 1, 2 and 3 years post-RT.

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“…The least-square fit can easily be calculated with an electronic sheet. 22 Today, patients sometimes come to urological examination with a high number of PSA measurements. The patient expects that the urologist evaluates his PSA list for an answer.…”

Section: Discussionmentioning

confidence: 99%

PSA velocity and PSA slope

Benecchi

2006

Prostate Cancer Prostatic Dis

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The aim of this study is to compare different tools for evaluating prostate-specific antigen (PSA) increase or decrease, such as PSA velocity and PSA slope. This study was conducted on 312 male patients evaluated with transrectal ultrasound-guided biopsy of prostate with six or more cores. Patients with at least three consecutive PSA measurements in at least 18 months entered the study. Prostate-specific antigen slope was estimated by the slope of the least-square regression line fit to PSA versus time in years; PSA velocity was calculated with 3 or more PSA arrays. Median age was 66 years (range 45-86). Overall 67 patients were affected by primary prostate cancer, 245 were controls without prostate cancer. Prostate-specific antigen slope and PSA velocity were significantly higher in patients with prostate cancer than in controls. At the ROC analysis, PSA slope evidenced better results than PSA velocity (area under the curve (AUC) 0.743 for PSA slope; AUC 0.663 for PSA velocity; P ¼ 0.037). At PSA slope (calculated with the least-square fit) equal to zero, the sensitivity resulted as being 94% with a specificity of 38.8%. In conclusion prostate-specific antigen slope calculated with three or more PSA assays permits longitudinal evaluation of PSA for prostate diagnosis. Prostate-specific antigen slope improves both sensitivity and specificity in prostate cancer diagnosis, compared with PSA velocity.

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A zero PSA slope in posttreatment prostate-specific antigen supports cure of patients with long-term follow-up after external beam radiotherapy for localized prostate cancer

Cited by 23 publications

References 11 publications

Dynamic contrast-enhanced magnetic resonance imaging and pharmacokinetic models in prostate cancer

Dynamic contrast-enhanced magnetic resonance imaging and pharmacokinetic models in prostate cancer

Hypofractionated SBRT Versus Conventionally Fractionated EBRT for Prostate Cancer: Comparison of PSA Slope and Nadir

PSA velocity and PSA slope

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