Prostate-specific antigen (PSA) rate of decline post external beam radiotherapy predicts prostate cancer death

Shi, Zumin; Pinnock, Carole; Kinsey-Trotman, Stephen; Borg, Martin; Moretti, Kim; Walsh, Scott; Kopsaftis, Tina

doi:10.1016/j.radonc.2013.03.030

Cited by 20 publications

(19 citation statements)

References 23 publications

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“…Interestingly, the efficacy of EBRT was better in biochemically relapsing patients, who showed larger α and lower surviving fractions (R d or R D ) than cured patients, even though these observations were statistically not significant (table 5). A dramatic decay of PSA following EBRT has also been linked to PCa recurrence in the literature [13]. We Table 5.…”

Section: A Robust Formulation Of Prostate-specific Antigen Dynamics Omentioning

confidence: 92%

Mechanistic modelling of prostate-specific antigen dynamics shows potential for personalized prediction of radiation therapy outcome

Lorenzo

Pérez-Garcı́a

Mariño

et al. 2019

J. R. Soc. Interface.

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External beam radiation therapy is a widespread treatment for prostate cancer. The ensuing patient follow-up is based on the evolution of the prostate-specific antigen (PSA). Serum levels of PSA decay due to the radiation-induced death of tumour cells and cancer recurrence usually manifest as a rising PSA. The current definition of biochemical relapse requires that PSA reaches nadir and starts increasing, which delays the use of further treatments. Also, these methods do not account for the post-radiation tumour dynamics that may contain early information on cancer recurrence. Here, we develop three mechanistic models of post-radiation PSA evolution. Our models render superior fits of PSA data in a patient cohort and provide a biological justification for the most common empirical formulation of PSA dynamics. We also found three model-based prognostic variables: the proliferation rate of the survival fraction, the ratio of radiation-induced cell death rate to the survival proliferation rate, and the time to PSA nadir since treatment termination. We argue that these markers may enable the early identification of biochemical relapse, which would permit physicians to subsequently adapt patient monitoring to optimize the detection and treatment of cancer recurrence.

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Section: A Robust Formulation Of Prostate-specific Antigen Dynamics Omentioning

confidence: 92%

Mechanistic modelling of prostate-specific antigen dynamics shows potential for personalized prediction of radiation therapy outcome

Lorenzo

Pérez-Garcı́a

Mariño

et al. 2019

J. R. Soc. Interface.

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“…Shi et al . described that a lower PSA at diagnosis had a lower PSA velocity following radiotherapy . High pretreatment median PSA might influence the slope of PSA decline.…”

Section: Discussionmentioning

confidence: 99%

Prostate‐specific antigen kinetics following hypofractionated stereotactic body radiotherapy versus conventionally fractionated external beam radiotherapy for low‐ and intermediate‐risk prostate cancer

Lee

Kim

2016

Asia-Pac J Clncl Oncology

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“…Although the direct comparison of rate of PSA decline with other study is not proper, the rate of PSA decline in our study tends to be more rapid than that of Anward et al (28) . Shi et al described that a lower PSA at diagnosis had a lower PSA velocity following radiotherapy (21) . The pretreatment median PSA level of 7.25 ng/mL in our study was slightly higher than 6.2 ng/mL in the report of Anwar et al Consistently.…”

Section: Discussionmentioning

confidence: 99%

“…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. Katz et al (4) demonstrated that PSA declines steadily after treatment and achieves very low mean levels of 0.25 ng/mL within 4~5 years.…”

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 (PSA) rate of decline post external beam radiotherapy predicts prostate cancer death

Cited by 20 publications

References 23 publications

Mechanistic modelling of prostate-specific antigen dynamics shows potential for personalized prediction of radiation therapy outcome

Mechanistic modelling of prostate-specific antigen dynamics shows potential for personalized prediction of radiation therapy outcome

Prostate‐specific antigen kinetics following hypofractionated stereotactic body radiotherapy versus conventionally fractionated external beam radiotherapy for low‐ and intermediate‐risk prostate cancer

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

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