Prostate-specific antigen bounce after high-dose-rate prostate brachytherapy and hypofractionated external beam radiotherapy

Patel, Nita; Souhami, Luís; Mansure, José João; Duclos, Marie; Aprikian, Armen; Faria, Sergio; David, Marc; Cury, Fabio

doi:10.1016/j.brachy.2014.05.005

Cited by 11 publications

(4 citation statements)

References 23 publications

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“…A systematic literature review was performed to identify studies reporting PSA bounce post-radiotherapy (see Materials and Methods for details) ( Figure 1 ). The search identified 50 studies including 26,258 patients, which were included in the analysis ( Table 1 ) [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. The number of studies and patients stratified by modality is summarized in Table S1 .…”

Section: Resultsmentioning

confidence: 99%

Characteristics of PSA Bounce after Radiotherapy for Prostate Cancer: A Meta-Analysis

Darwis

Oike

Kubo

et al. 2020

Cancers

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The rate and characteristics of prostate-specific antigen (PSA) bounce post-radiotherapy remain unclear. To address this issue, we performed a meta-analysis. Reports of PSA bounce post-radiotherapy with a cutoff of 0.2 ng/mL were searched by using Medline and Web of Science. The primary endpoint was the occurrence rate, and the secondary endpoints were bounce characteristics such as amplitude, time to occurrence, nadir value, and time to nadir. Radiotherapy modality, age, risk classification, androgen deprivation therapy, and the follow-up period were extracted as clinical variables. Meta-analysis and univariate meta-regression were performed with random-effect modeling. Among 290 search-positive studies, 50 reports including 26,258 patients were identified. The rate of bounce was 31%; amplitude was 1.3 ng/mL; time to occurrence was 18 months; nadir value was 0.5 ng/mL; time to nadir was 33 months. Univariate meta-regression analysis showed that radiotherapy modality (29.7%), age (20.2%), and risk classification (12.2%) were the major causes of heterogeneity in the rate of bounce. This is the first meta-analysis of PSA bounce post-radiotherapy. The results are useful for post-radiotherapy surveillance of prostate cancer patients.

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Section: Resultsmentioning

confidence: 99%

Characteristics of PSA Bounce after Radiotherapy for Prostate Cancer: A Meta-Analysis

Darwis

Oike

Kubo

et al. 2020

Cancers

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“…Seven patients had large PSA bounces. In the large bounce population, the median PSA value at pre-bounce nadir was 1.91 ng/mL (IQR, 0.44-3.29), and the median time to pre-bounce nadir was 11 months (IQR, [7][8][9][10][11][12]. The median time to large bounce was 24 months (IQR, [16][17][18][19][20][21][22][23][24][25][26][27][28][29] after LDR-BT.…”

Section: Analysis Of Large Bounce Phenomenonmentioning

confidence: 99%

“…PSA bounce, a temporary increase in PSA levels and a subsequent decrease without intervention, occurs in 15-84% of men receiving 125 I BT [5]. Several studies and trials have demonstrated that PSA bounce after 125 I BT is a good prognostic factor [5,6], and young age is generally accepted as a predictive factor for PSA bounce [7,8]. In addition, few studies have investigated the difference between biochemical failure and PSA bounce [9][10][11], and most of them were single-center studies with several limitations.…”

Section: Introductionmentioning

confidence: 99%

Prostate-Specific Antigen Bounce after 125I Brachytherapy Using Stranded Seeds with Intraoperative Optimization for Prostate Cancer

Kim

Lee

Cho

2022

Cancers

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Prostate-specific antigen (PSA) bounce is common in patients undergoing 125I brachytherapy (BT), and our study investigated its clinical features. A total of 100 patients who underwent BT were analyzed. PSA bounce and large bounce were defined as an increase of ≥ 0.2 and ≥ 2.0 ng/mL above the initial PSA nadir, respectively, with a subsequent decline without treatment. Biochemical failure was defined using the Phoenix definition (nadir +2 ng/mL), except for a large bounce. With a median follow-up of 49 months, 45% and 7% of the patients experienced bounce and large bounce, respectively. The median time to bounce was 24 months, and the median PSA value at the bounce spike was 1.62 ng/mL, a median raise of 0.44 ng/mL compared to the pre-bounce nadir. The median time to bounce recovery was 4 months. The post-bounce nadir was obtained at a median of 36 months after low-dose-rate BT. On univariate analysis, age, the PSA nadir value at 2 years, and prostate volume were significant factors for PSA bounce. The PSA nadir value at 2 years remained significant in multivariate analysis. We should carefully monitor young patients with high prostate volume having a > 0.5 PSA nadir value at 2 years for PSA bounce.

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“…Survival outcome data from multiple centers involving larger patient populations is needed to critically determine the utility of NCCN risk subclassification. Fourth, despite being a major prognostic factor, PSA bounce was not included in our analysis, because our study protocol meant that adjuvant ADT may still have been effective enough to affect the occurrence of PSA bounces when the patients were most likely to have been susceptible to them [26,27]. Fifth, the AEs reported in this study were not presented as early/late toxicities due to a paucity of relevant data in our database.…”

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confidence: 99%

Trimodal therapy with high-dose-rate brachytherapy and hypofractionated external beam radiation combined with long-term androgen deprivation for unfavorable-risk prostate cancer

et al. 2021

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Purpose To assess the outcomes of high-dose-rate (HDR) brachytherapy and hypofractionated external beam radiation therapy (EBRT) combined with long-term androgen deprivation therapy (ADT) in very-high-risk (VHR) versus high-risk (HR) prostate cancer (PCa), as defined in the National Comprehensive Cancer Network (NCCN) criteria. Methods Data from 338 consecutive HR or VHR PCa patients who had undergone this tri-modal therapy between 2005 and 2018 were retrospectively analyzed. Biochemical recurrence (BCR)-free, progression-free, overall, and cancer-specific survival (BCRFS/PFS/OS/CSS) rates were analyzed using the Kaplan–Meier method and Wilcoxon test. Cox regression models were used to evaluate candidate prognostic factors for survival. C‑indexes were used to assess model discrimination. Results Within a median follow-up of 84 months, 68 patients experienced BCR, 58 had disease progression including only 3 with local progression, 27 died of any cause, and 2 died from PCa. The 5‑year BCRFS, PFS, OS, and CSS rates were 82.2% (HR 86.5%; VHR 70.0%), 90.0% (HR 94.3%; VHR 77.6%), 95.7% (HR, 97.1%; VHR, 91.8%), and 99.6% (HR, 100%; VHR, 98.0%), respectively. In multivariable analyses that adjusted for standard clinicopathologic features, the risk subclassification was associated both PFS and OS (p = 0.0003 and 0.001, respectively). Adding the risk subclassification improved the accuracy of models in predicting BCRFS, PFS, and OS. Conclusion While the outcome of this trimodal approach appears favorable, VHR PCa patients had significantly worse oncological outcomes than those with HR PCa. The NCCN risk subclassification should be integrated into prognostic tools to guide risk stratification, treatment, and follow-up for unfavorable PCa patients receiving this trimodal therapy.

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Prostate-specific antigen bounce after high-dose-rate prostate brachytherapy and hypofractionated external beam radiotherapy

Cited by 11 publications

References 23 publications

Characteristics of PSA Bounce after Radiotherapy for Prostate Cancer: A Meta-Analysis

Characteristics of PSA Bounce after Radiotherapy for Prostate Cancer: A Meta-Analysis

Prostate-Specific Antigen Bounce after 125I Brachytherapy Using Stranded Seeds with Intraoperative Optimization for Prostate Cancer

Trimodal therapy with high-dose-rate brachytherapy and hypofractionated external beam radiation combined with long-term androgen deprivation for unfavorable-risk prostate cancer

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