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01-04-2013 | Original Article

Prostate-specific antigen kinetics after I125-brachytherapy for prostate adenocarcinoma

Authors: Alessia Guarneri, Angela Botticella, Riccardo Ragona, Andrea Riccardo Filippi, Fernando Munoz, Giovanni Casetta, Paolo Gontero, Alessandro Tizzani, Umberto Ricardi

Published in: World Journal of Urology | Issue 2/2013

Abstract

Purpose

To investigate a potential correlation between the achievement of a cut-off of nadir PSA (nPSA) after brachytherapy (BRT) with biochemical Disease-Free Survival (bDFS) and to define the rate of post-BRT PSA bounces.

Methods

Retrospective analysis was carried out in 105 consecutive patients affected with early-stage prostate adenocarcinoma who underwent ¹²⁵I BRT. Only patients with a minimum follow-up ≥24 months were included. Biochemical DFS was chosen as primary endpoint.

Results

At a median follow-up of 51.2 months, 3- and 5-year bDFS were 96.8 and 91.2 %, respectively. Median time to biochemical failure (BF) was 54 months. By Kaplan–Meier analysis, patients achieving nPSA ≤ 0.35 ng/mL had significantly higher bDFS (3- and 5-year bDFS: 100 and 98.5 % vs 83.3 and 66.7 %, respectively; p = 0.001). Bounce PSA occurred in 28.6 % of patients, at a median time of 21.5 months. No BFs were observed in the bounce group. Achieving a nPSA ≤ 0.35 ng/mL was the only factor independently associated with long-term bDFS on both univariate (p = 0.000) and multivariate analysis (HR 3.82; p = 0.003).

Conclusions

Patients attaining a nPSA ≤ 0.35 ng/mL are significantly more likely to experience long-term freedom-from-biochemical failure. Bounce PSA occurs in approximately 30 % of patients. Time to onset of PSA increase seems the most reliable feature to distinguish bounce from failure. Tailored follow-up strategies are needed for patients at higher risk of recurrence, and caution is advised in interpreting an early increase in PSA levels in the first 24–30 months after BRT.

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Title: Prostate-specific antigen kinetics after I125-brachytherapy for prostate adenocarcinoma
Authors: Alessia Guarneri
Angela Botticella
Riccardo Ragona
Andrea Riccardo Filippi
Fernando Munoz
Giovanni Casetta
Paolo Gontero
Alessandro Tizzani
Umberto Ricardi
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 2/2013
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-012-0932-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prostate-specific antigen kinetics after I125-brachytherapy for prostate adenocarcinoma

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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