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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

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Congratulations to top alumni honour awardee Dr. Ron Moore

Congratulations to Dr. Ron Moore, ’80 BSc, ’86 MD, ’91 PhD, who will receive an Alumni Honour Award from University of Alberta President David H. Turpin during the Alumni Awards Ceremony on Monday, Sept. 24, 2018, at the Northern Alberta Jubilee Auditorium in Edmonton.
The Alumni Honour Award recognizes the significant achievements and contributions by University of Alberta alumni to their profession and their community. Dr. Moore has made significant contributions to advancing our knowledge and treatment of bladder, kidney and prostate cancer. He has studied and developed laser treatment as therapy for prostate and bladder cancer, and developed new drugs to improve prostate cancer radiotherapy outcomes. Dr. Ron Moore has also actively mentored and trained hundreds of students throughout his career as well as serving on the APCaRI leadership committee.

The community is invited to celebrate as Dr. Ron Moore receives this top alumni award!
Date: Monday, Sept. 24, 2018
Location: Northern Alberta Jubilee Auditorium (11455 87 Ave), Edmonton, Alberta
Time: 7 p.m. ceremony with dessert reception to follow
Cost: Free, register for tickets
Dress: Business attire

For more information, please contact the Office of Alumni Relations at 780-492-3224, toll free 1-800-661-2593 or alumni@ualberta.ca
Featured at @UAlbertaAlumni and in the New Trail magazine.

- Perrin Beatty