Reference : Prognostic value of PSA nadir < or =4 ng/ml within 4 months of high-dose radiotherapy fo...
Scientific journals : Article
Human health sciences : Oncology
Human health sciences : Radiology, nuclear medicine & imaging
http://hdl.handle.net/2268/4704
Prognostic value of PSA nadir < or =4 ng/ml within 4 months of high-dose radiotherapy for locally advanced prostate cancer
English
Nickers, Philippe [Université de Liège - ULg > > Département des sciences cliniques >]
Albert, Adelin mailto [Université de Liège - ULg > Département des sciences de la santé publique > Informatique médicale et biostatistique >]
Waltregny, David mailto [Université de Liège - ULg > Département des sciences biomédicales et précliniques > Labo de recherche sur les métastases >]
Deneufbourg, Jean-Marie mailto [Université de Liège - ULg > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine) >]
1-May-2006
International Journal of Radiation, Oncology, Biology, Physics
Elsevier Science Inc
65
1
73-77
Yes (verified by ORBi)
International
0360-3016
New York
[en] prostate ; PSA ; kinetics ; nadir ; radiotherapy
[en] PURPOSE: To investigate early prostate-specific antigen (PSA) kinetics after high radiation doses of 85 Gy on locally advanced prostate cancer. METHODS AND MATERIALS: A total of 201 patients were prospectively and consecutively treated with external beam radiotherapy and a brachytherapy boost. Of the 201 patients, 104 received concomitant hormonal therapy on the decision of the referring urologist and were excluded, yielding a study population of 97 patients. The first posttreatment PSA analysis was performed not earlier than 1 month after treatment completion but within the first 4 months, and then every 4 months. Analysis of PSA kinetics included the PSA nadir (nPSA) at values of < or =4 ng/mL to < or =0.5 ng/mL. The nPSA at < or =4 ng/mL within 4 months (nPSA < or =4/4m) was the variable of interest. RESULTS: We established highly significant associations between an nPSA of < or =1 and < or =0.5 ng/mL and the nPSA < or =4/4m (p <0.0001). A hazard ratio of 0.33 (95% Confidence Interval (CI), 0.12-0.91) underlined the lower risk of recurrence related to nPSA < or =4/4m achievement (p = 0.033). Using time-dependent covariate models for patients who did not reach an nPSA < or =4/4m, an nPSA of < or =1 ng/mL remained without prognostic significance (p = 0.06). However, for patients who reached an nPSA < or =4/4m, an nPSA of < or =1 ng/mL did significantly improve the prognosis (p <0.001), but much later after treatment. The same analysis was repeated for nPSA < or =0.5 ng/mL with similar conclusions as when nPSA < or =4/4m was obtained (p <0.01). CONCLUSION: The nPSA < or =4/4m has been demonstrated to be a significant predictor of biochemical no evidence of disease after high radiation doses of 85 Gy. Its major advantage is that it was available earlier than the other nadirs.
http://hdl.handle.net/2268/4704
10.1016/j.ijrobp.2005.11.026

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