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Open Access 01-12-2012 | Research

Permanent ¹²⁵I-seed prostate brachytherapy: early prostate specific antigen value as a predictor of PSA bounce occurrence

Authors: Renaud Mazeron, Agathe Bajard, Xavier Montbarbon, Frédéric Gassa, Claude Malet, François Rocher, Sébastien Clippe, Gabriel Bringeon, Olivier Desmettre, Pascal Pommier

Published in: Radiation Oncology | Issue 1/2012

Abstract

Purpose

To evaluate predictive factors for PSA bounce after ¹²⁵I permanent seed prostate brachytherapy and identify criteria that distinguish between benign bounces and biochemical relapses.

Materials and methods

Men treated with exclusive permanent ¹²⁵I seed brachytherapy from November 1999, with at least a 36 months follow-up were included. Bounce was defined as an increase ≥ 0.2 ng/ml above the nadir, followed by a spontaneous return to the nadir. Biochemical failure (BF) was defined using the criteria of the Phoenix conference: nadir +2 ng/ml.

Results

198 men were included. After a median follow-up of 63.9 months, 21 patients experienced a BF, and 35.9% had at least one bounce which occurred after a median period of 17 months after implantation (4-50). Bounce amplitude was 0.6 ng/ml (0.2-5.1), and duration was 13.6 months (4.0-44.9). In 12.5%, bounce magnitude exceeded the threshold defining BF. Age at the time of treatment and high PSA level assessed at 6 weeks were significantly correlated with bounce but not with BF. Bounce patients had a higher BF free survival than the others (100% versus 92%, p = 0,007). In case of PSA increase, PSA doubling time and velocity were not significantly different between bounce and BF patients. Bounces occurred significantly earlier than relapses and than nadir + 0.2 ng/ml in BF patients (17 vs 27.8 months, p < 0.0001).

Conclusion

High PSA value assessed 6 weeks after brachytherapy and young age were significantly associated to a higher risk of bounces but not to BF. Long delays between brachytherapy and PSA increase are more indicative of BF.

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Title: Permanent 125I-seed prostate brachytherapy: early prostate specific antigen value as a predictor of PSA bounce occurrence
Authors: Renaud Mazeron
Agathe Bajard
Xavier Montbarbon
Frédéric Gassa
Claude Malet
François Rocher
Sébastien Clippe
Gabriel Bringeon
Olivier Desmettre
Pascal Pommier
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2012
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-7-46

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Permanent ¹²⁵I-seed prostate brachytherapy: early prostate specific antigen value as a predictor of PSA bounce occurrence

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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