Publications

Publications

Distinguishing prostate-specific antigen bounces from biochemical failure after low-dose-rate prostate brachytherapy.

By:
Contributors: Nawaid Usmani, MD, FRCPC, Sunita Ghosh, PhD
J Contemp Brachytherapy. 2014 Oct;6(3):247-53. doi: 10.5114/jcb.2014.45093. Epub 2014 Sep 5.

Abstract

PURPOSE:

The purpose of this study was to characterize benign prostate-specific antigen (PSA) bounces of at least 2.0 ng/mL and biochemical failure as defined by the Phoenix definition after prostate brachytherapy at our institution, and to investigate distinguishing features between three outcome groups: patients experiencing a benign PSA bounce, biochemical failure, or neither.

MATERIAL AND METHODS:

Five hundred and thirty consecutive men treated with low-dose-rate brachytherapy with follow-up of at least 3 years were divided into outcome groups experiencing bounce, failure, or neither. A benign bounce was defined as a rise of at least 2.0 ng/mL over the pre-rise nadir followed by a decline to 0.5 ng/mL or below, without intervention. Patient and tumor characteristics, treatment variables, and PSA kinetics were analyzed between groups.

RESULTS:

Thirty-two (6.0%) men experienced benign bounces and 47 (8.9%) men experienced failure. Men experiencing a bounce were younger (p = 0.01), had a higher 6-month PSA level (p = 0.03), and took longer to reach a final nadir (p < 0.01). Compared to the failure group, men with bounce had a lower pre-treatment PSA level (p = 0.01) and experienced a rise of at least 2.0 ng/mL that occurred sooner after the implant (p < 0.01) with a faster PSA doubling time (p = 0.01). Only time to PSA rise independently differentiated between bounce and failure (p < 0.01), with a benign bounce not being seen after 36 months post-treatment. Prostate-specific antigen levels during a bounce reached levels as high as 12.6 ng/mL in this cohort, and in some cases took over 5 years to decline to below 0.5 ng/mL.

CONCLUSIONS:

Although there is substantial overlap between the features of benign PSA bounces and failure, physicians may find it useful to evaluate the timing, absolute PSA level, initial response to treatment, and rate of rise when contemplating management for a PSA rise after low-dose-rate brachytherapy.

PubMed

Download PDF

 

Stay Informed

To stay up to date on all the latest news and publications, subscribe to our newsletter!

APCaRI members participate in the 2016 CCI Golf Classic

Members of the APCaRI team felt very fortunate yesterday to participate in the Alberta Cancer Foundation’s 28th Annual Cross Cancer Institute Golf Classic – a wonderful event that has raised more than $12 million to pioneer revolutionary projects in support of patients at Alberta’s own Cross Cancer Institute and beyond.

Over the past 27 years, the Cross Cancer Institute Golf Classic has funded leading edge research, treatment and patient care programs at the Cross Cancer Institute. In 2016, the Alberta Cancer Foundation embarked on a new investment that will bring together the brightest minds in colorectal cancer research to increase survival rates and improve quality of life for colorectal patients across the province.

Heartfelt thanks to the amazing volunteers, the organizing committee, the Alberta Cancer Foundation, and all of the participants!

 

 

 

- Catalina Vasquez

Our International Network of Partners

Meeting these ambitious goals will not be possible without the committed engagement of our many partners across Alberta, Canada and the World. Learn more about our Partners.