BACKGROUND:To clarify the significant clinicopathological and postdosimetric parameters to predict PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy) for prostate cancer.
METHODS:We studied 200 consecutive patients who received LDR-brachytherapy between July 2004 and November 2008. Of them, 137 patients did not receive neoadjuvant or adjuvant androgen deprivation therapy. One hundred and forty-two patients were treated with LDR-brachytherapy alone, and 58 were treated with LDR-brachytherapy in combination with external beam radiation therapy. The cut-off value of PSA bounce was 0.1 ng/mL. The incidence, time, height, and duration of PSA bounce were investigated. Clinicopathological and postdosimetric parameters were evaluated to elucidate independent factors to predict PSA bounce in hormone-naive patients who underwent LDR-brachytherapy alone.
RESULTS:Fifty patients (25%) showed PSA bounce and 10 patients (5%) showed PSA failure. The median time, height, and duration of PSA bounce were 17 months, 0.29 ng/mL, and 7.0 months, respectively. In 103 hormone-naive patients treated with LDR-brachytherapy alone, and univariate Cox proportional regression hazard model indicated that age and minimal percentage of the dose received by 30% and 90% of the urethra were independent predictors of PSA bounce. With a multivariate Cox proportional regression hazard model, minimal percentage of the dose received by 90% of the urethra was the most significant parameter of PSA bounce.
CONCLUSIONS: Minimal percentage of the dose received by 90% of the urethra was the most significant predictor of PSA bounce in hormone-naive patients treated with LDR-brachytherapy alone.
Written by:
Tanaka N, Asakawa I, Fujimoto K, Anai S, Hirayama A, Hasegawa M, Konishi N, Hirao Y. Are you the author?
Reference: BMC Urol. 2012 Sep 14;12(1):28. Epub ahead of print.
doi: 10.1186/1471-2490-12-28
PubMed Abstract
PMID: 22974428
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