The PSA nadir that indicates potential cure after radiotherapy for prostate cancer

Critz, Frank A.; Levinson, Adam W.; Williams, W. Hamilton; Holladay, David A.; Holladay, C.T.; Klein, Eric A.; Kupelian, Patrick

doi:10.1016/s0090-4295(96)00666-8

Cited by 74 publications

(25 citation statements)

References 21 publications

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“…Critz et al 5,13,14,[21][22][23][24][25] have conducted numerous studies in an attempt to define the PSA nadir value that defines freedom from disease for men treated with combined BT and EBRT for localized prostate carcinoma. One study 22 reported on 660 men with T1-2N0 prostate carcinoma who were treated with an iodine-125 ( 125 I) BT implant followed by radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…One study 22 reported on 660 men with T1-2N0 prostate carcinoma who were treated with an iodine-125 ( 125 I) BT implant followed by radiotherapy. Recurrence was defined as a PSA rising above whatever nadir was achieved.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][7][8][9][10][11][12][13][14][15][21][22][23][24][25][26][27][28] For the current study, we defined it as a PSA level of Ն 1.0 ng/mL. "Disease-free survival" (DFS) is defined as the time from 103 Pd implant to biochemical failure or last follow-up in patients without biochemical failure.…”

Section: Endpoints and Patient Exclusion Criteriamentioning

confidence: 99%

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Undetectable prostate specific antigen at 6–12 months

Miller

Smolkin

Bissonette

et al. 2005

Cancer

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Objective Treatment guidelines for rheumatoid arthritis (RA) now recommend early, aggressive, and persistent use of disease‐modifying antirheumatic drugs (DMARDs) to prevent joint damage in all people with active inflammation, and evaluation by a rheumatologist, when possible. This research assesses whether care for RA, at a population level, is consistent with current treatment guidelines. Methods Using administrative billing data from the Ministry of Health in 1996–2000, all prevalent RA cases in British Columbia, Canada were identified. Data were obtained on all medications and all provincially‐funded health care services. Results We identified 27,710 RA cases, yielding a prevalence rate of 0.76%, consistent with epidemiologic studies. DMARD use was inappropriately low. Only 43% of the entire RA cohort received a DMARD at least once over 5 years, and 35% over 2 years. When used, DMARDs were started in a timely fashion, but were not used consistently. Care by a rheumatologist increased DMARD use 31‐fold. Yet, only 48% and 34% saw a rheumatologist over 5 and 2 years, respectively. DMARD use was significantly more frequent, persistent, and more often used as combination therapy with continuous rheumatologist care. DMARDs were used by 84% and 73%, 40%, and 10% of people followed by rheumatologists continuously and intermittently, internists, and family physicians, respectively (P < 0.001). NSAID use, physiotherapy, and orthopedic surgeries were similar across these 4 care groups. Conclusion RA care in the British Columbia population was not consistent with current treatment guidelines. Efforts to educate family physicians and consumers about the shift in RA treatment paradigms and to improve access to rheumatologists are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Undetectable prostate specific antigen at 6–12 months

Miller

Smolkin

Bissonette

et al. 2005

Cancer

View full text Add to dashboard Cite

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“…31 Critz et al propose a PSA nadir of 0.5 ng/mL or more as the endpoint for brachytherapy treatment failure, demonstrating signi®cant 5 and 10-year disease-free survival rates in those with nadir PSA values less than 0.5 ng/mL. 32,33 However, the prognostic value of this nadir depends on most men achieving a nadir of 0.2 ng/mL or less. 34 Time to reach PSA nadir varies with treatment modality.…”

Section: Identifying Recurrence and Its Sitementioning

confidence: 99%

“…35 Patterns of PSA failure, such as time to failure, nadir PSA reached, time to nadir PSA level, and PSA velocity, are current methods to further evaluate for treatment failure. 32,33,36,37 Another confounding factor in patients treated with radiation therapy is the concomitant use of androgen deprivation. No standard regimens or recommendations exist to address the optimal timing and duration of neoadjuvant and adjuvant hormonal therapy, resulting in dif®culty assessing treatment success, degree of recurrence, and ef®cacy (ie disease-speci®c survival) of salvage therapy.…”

Section: Identifying Recurrence and Its Sitementioning

confidence: 99%