Prostate-specific antigen decline: a major prognostic factor for prostate cancer treated with radiation therapy.

Chauvet, B.; Félix-Faure, C.; Lupsascka, N; Fijuth, Jacek; Brewer, Y.; Davin, J L; Kirscher, Sylvie; Reboul, F.

doi:10.1200/jco.1994.12.7.1402

Cited by 42 publications

(22 citation statements)

References 17 publications

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“…The interpretation of the PSA rate of decline following radiotherapy, as measured by the PSA slope, is more controversial. Some studies have shown a relationship between the magnitude of the PSA slope and clinical outcomes [35,37], while other studies have not [38-40]. Regardless, the rate of PSA decline is reflective of the cellular response to radiation.…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated SBRT versus conventionally fractionated EBRT for prostate cancer: comparison of PSA slope and nadir

et al. 2014

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BackgroundPatients 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/methods75 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 (1997–2012). 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.ResultsThe median PSA nadir and slope for CF-EBRT was 1.00, 0.72 and 0.60 ng/ml and -0.09, -0.04, -0.02 ng/ml/month, respectively, for durations of 1, 2 and 3 years post RT. Similarly, for SBRT, the median PSA nadirs and slopes were 0.70, 0.40, 0.24 ng and -0.09, -0.06, -0.05 ng/ml/month, respectively. The PSA slope for SBRT was greater than CF-EBRT (p < 0.05) at 2 and 3 years following RT, although similar during the first year. Similarly, PSA nadir was significantly lower for SBRT when compared to EBRT for years 2 and 3 (p < 0.005).ConclusionPatients treated with SBRT experienced a lower PSA nadir and greater rate of decline in PSA 2 and 3 years following completion of RT than with CF-EBRT, consistent with delivery of a higher bioequivalent dose. Although follow-up for SBRT is limited, the improved PSA kinetics over CF-EBRT are promising for improved biochemical control.

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Section: Introductionmentioning

confidence: 99%

Hypofractionated SBRT versus conventionally fractionated EBRT for prostate cancer: comparison of PSA slope and nadir

et al. 2014

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“…The interpretation of the PSA rate of decline following radiotherapy, as measured by the PSA slope, is more controversial. Some studies have shown a relationship between the magnitude of the PSA slope and clinical outcomes [35,37], while other studies have not [38][39][40]. Regardless, the rate of PSA decline is reflective of the cellular response to radiation.…”

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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“…Benign PSA bounces were common with 33.3% of all patients. The median time to PSA bounce was 13 months (range, [6][7][8][9][10][11][12][13][14][15][16][17][18]. The median height of PSA bounce was 0.34 ng/mL (range, 0.21-1.39).…”

Section: Resultsmentioning

confidence: 99%

“…While recent studies have demonstrated that a lower PSA nadir (<0.5 ng/ mL) has been associated with superior clinical disease-free survival (15,16) , the interpretation of the decline rate of PSA following radiotherapy is controversial. Some reports have shown a positive relationship between the increase of the decline rate and clinical outcome, while others have negative (11,(17)(18)(19)(20) . Shi et al (21) reported that a rapid PSA decline in the !irst year after external beam radiotherapy is positively associated with prostate cancer speci!ic mortality.…”

Section: Introductionmentioning

confidence: 99%

Prostate-specific antigen kinetics after hypofractionated stereotactic body radiotherapy for localized prostate cancer

Kim

Phak

Kim

2016

IJRR

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Background: stereotac c body radiotherapy (SBRT) has emerged as an effec ve treatment for localized prostate cancer. However, prostate-specific an gen (PSA) kine cs a'er SBRT has not been well characterized. The objec ve of the current study is to analyze the rate of PSA decline and PSA nadir following hypofractonated SBRT in localized prostate cancer. Materials and Methods: From 2008 to 2014, thirty-nine pa ents newly diagnosed, localized prostate (25.6% low risk, 66.7% intermediate risk and 7.7% high risk) cancer were treated with SBRT using Cyberknife. Total dose of 36.25 Gy in 5 frac ons of 7.25 Gy were administered. No one received androgen depriva on therapy (ADT). PSA nadir and rate of change in PSA (slope) were calculated and compared. Results: With a median follow-up of 52 months (range, 13-71), the median rates of decline of PSA were -0.372, -0.211 and -0.128 ng/mL/month, respec vely, for dura ons of 1, 2 and 3 years a'er radiotherapy, respec vely. The decline of PSA was maximal in the first year and con nuously decreased for dura ons of 2 and 3 year. The median PSA nadir was 0.28 ng/mL a'er a median 33 months. There was one biochemical failure, occurring in a high risk pa ent. 5-year actuarial biochemical failure (BCF) free survival was 94.2%. Conclusion: In this report of localized prostate cancer, con nuous decrease of PSA level for dura on 1, 2 and 3 year following SBRT using Cyberknife resulted in lower PSA nadir. Also, SBRT leaded to long-term favorable BCF-free survival.

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Prostate-specific antigen decline: a major prognostic factor for prostate cancer treated with radiation therapy.

Cited by 42 publications

References 17 publications

Hypofractionated SBRT versus conventionally fractionated EBRT for prostate cancer: comparison of PSA slope and nadir

Hypofractionated SBRT versus conventionally fractionated EBRT for prostate cancer: comparison of PSA slope and nadir

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

Prostate-specific antigen kinetics after hypofractionated stereotactic body radiotherapy for localized prostate cancer

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