Prostate-specific antigen dynamics after neoadjuvant androgen-deprivation therapy and carbon ion radiotherapy for prostate cancer

Abstract

Background This study aimed to explain the dynamics of prostate-specific antigen (PSA) levels in patients with prostate cancer who were treated with carbon ion radiotherapy (CIRT) and neoadjuvant androgen-deprivation therapy (ADT). Methods Eighty-five patients with intermediate-risk prostate cancer who received CIRT and neoadjuvant ADT from December 2015 to December 2017 were analyzed in the present study. The total dose of CIRT was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. The PSA bounce was defined as a ≥0.4 ng/ml increase of PSA levels from the nadir, followed by any decrease. PSA failure was defined using the Phoenix criteria. Results The median patient age was 68 (range, 48–81) years. The median follow-up duration was 33 (range, 20–48) months. The clinical T stage was T1c, T2a, and T2b in 27, 44, and 14 patients, respectively. The Gleason score was 6 in 3 patients and 7 in 82 patients. The median pretreatment PSA level was 7.37 (range, 3.33–19.0) ng/ml. All patients received neoadjuvant ADT for a median of 6 (range, 2–117) months. PSA bounces were observed in 39 patients (45.9%), occurring a median of 12 (range, 6–30) months after CIRT. PSA failure was observed in eight patients (9.4%), occurring a median of 21 (range, 15–33) months after CIRT. The 3-year PSA failure-free survival rate was 88.5%. No clinical recurrence was observed during the follow-up period. Younger age and lower T stage were significant predictors of PSA bounce. Younger age was a significant predictor of PSA failure. Conclusions In this study, we identified the significant predictors of the occurrence of PSA bounce and failure. Further follow-up is needed to reveal the clinical significance of PSA dynamics.

Clinical Outcomes of Radiotherapy in Elderly and Younger Patients with T4 Esophageal Cancer: A Retrospective Single-Center Analysis

“…The correlation of clinical variables with OS was assessed via Cox regression analyses. Prognostic factors, for which p values were calculated as < 0.10, were evaluated using the multivariate stepwise Cox regression model [19]. A p value of < 0.05 was considered signi cant.…”

Clinical Outcomes of Radiotherapy in Elderly and Younger Patients With T4 Esophageal Cancer: A Retrospective Single-center Analysis

“…The correlation of clinical variables with OS was assessed via Cox regression analyses. Prognostic factors, for which p-values were calculated as <0.10, were evaluated using the multivariate stepwise Cox regression model (19). A p-value of <0.05 was considered significant.…”

Five-year clinical outcomes of scanning carbon-ion radiotherapy for prostate cancer

“…Darwis NDM et al reported that the PSA bounce was observed in 55.7% of patients, out of which 97.6% experienced an increase of less than 2.0 ng/ml [22]. In our previous study, we investigated PSA kinetics after the combination of neoadjuvant ADT and sCIRT in 85 patients with prostate cancer in the intermediate-risk group [23]. In that study, PSA elevations above the nadir PSA plus 2 ng/ml occurred in eight cases, of which seven experienced spontaneous declines in the PSA level.…”