Nadir PSA is a strong predictor of treatment outcome in intermediate and high risk localized prostate cancer patients treated by definitive external beam radiotherapy and androgen deprivation

被引:29
|
作者
Geara, Fady B. [1 ]
Bulbul, Muhammad [2 ]
Khauli, Raja B. [2 ]
Andraos, Therese Y. [1 ]
Abboud, Mirna [1 ]
Al Mousa, Abdelatif [3 ]
Sarhan, Nasim [3 ]
Salem, Ahmed [3 ]
Ghatasheh, Hamza [3 ]
Alnsour, Anoud [3 ]
Ayoub, Zeina [1 ]
Abu Gheida, Ibrahim [1 ]
Charafeddine, Maya [1 ]
Shahait, Mohammed [1 ]
Shamseddine, Ali [4 ]
Abu Gheida, Rami [2 ]
Khader, Jamal [3 ]
机构
[1] Amer Univ Beirut, Med Ctr, Naef K Basile Canc Inst, Dept Radiat Oncol, Bliss St, Beirut 11072030, Lebanon
[2] Amer Univ Beirut, Med Ctr, Div Urol, Beirut, Lebanon
[3] King Hussein Canc Ctr, Dept Radiat Oncol, Amman, Jordan
[4] Amer Univ Beirut, Med Ctr, Naef K Basile Canc Inst, Div Med Oncol, Beirut, Lebanon
关键词
Prostate cancer; External beam radiation therapy; Androgen deprivation; Nadir PSA; RADIATION-THERAPY; ANTIGEN NADIR; BIOCHEMICAL RESPONSE; SUPPRESSION; MEN; MORTALITY; SURVIVAL; FAILURE; TIME; RTOG;
D O I
10.1186/s13014-017-0884-y
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The aim of this study is to investigate the effect of tumor characteristics and parameters of treatment response in predicting biochemical disease-free survival (BFS) for patients with intermediate or high risk prostate cancer treated by combined definitive external beam radiation therapy (EBRT) and androgen deprivation therapy (ADT). Methods: Between June 1995 and January 2015, 375 patients with localized prostate cancer and a National Comprehensive Cancer Network (NCCN) intermediate or high risk categories were treated by definitive EBRT and ADT. Median duration of androgen blockade was 10 months (range: 3-36 months); Median radiation dose was 72 Gy (Range: 70-78 Gy). Median follow-up time was 5.8 years (range: 0.8-16.39 years). The main study endpoint was biochemical disease free survival (BFS). Results: Forty seven patients (12.5%) developed biochemical recurrence (BCR) during the observation period. Monovariate analysis identified baseline PSA (bPSA) (p = 0.024), T-stage (p = 0.001), Gleason's score (GS) (p = 0.042), radiation dose (p = 0.045), PSA pre-radiation therapy (p = 0.048), and nadir PSA (nPSA), (p < 0.001) as significant variables affecting BCR. The receiver operating characteristic (ROC) curve identified a nPSA of 0.06 ng/ml as optimal cut-off value significantly predicting the patients' risk of BCR (p < 0.001). Multivariate cox regression analysis revealed T-stage, GS, and nPSA as independent variable affecting BFS, while bPSA, age, and radiation dose were not. Conclusion: Nadir PSA at 0.06 is a strong independent predictor of BFS in patients with intermediate or high risk prostate cancer treated by definitive EBRT and ADT.
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页数:8
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