Interval to Biochemical Failure Highly Prognostic for Distant Metastasis and Prostate Cancer-Specific Mortality After Radiotherapy
Purpose Few biochemical parameters have been related to mortality. The present study examined the clinical utility of the interval to biochemical failure (IBF) as a prognostic factor for distant metastasis (DM) and prostate cancer-specific mortality (PCSM) after radiotherapy. Methods and Materials T...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2008, Vol.70 (1), p.59-66 |
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| creator | Buyyounouski, Mark K., M.D., M.S Hanlon, Alexandra L., Ph.D Horwitz, Eric M., M.D Pollack, Alan, M.D., Ph.D |
| description | Purpose Few biochemical parameters have been related to mortality. The present study examined the clinical utility of the interval to biochemical failure (IBF) as a prognostic factor for distant metastasis (DM) and prostate cancer-specific mortality (PCSM) after radiotherapy. Methods and Materials The study group consisted of 211 T1c-T3Nx-N0M0 patients who had experienced BF among 1,174 men treated with three-dimensional conformal radiotherapy alone. Biochemical failure was defined as a post-treatment prostate-specific antigen (PSA) level of at, or greater than, the PSA nadir plus 2 ng/mL. Cox proportional hazards modeling was used to identify independent predictors of DM and PCSM on multivariate analysis. Results An IBF of |
| doi_str_mv | 10.1016/j.ijrobp.2007.05.047 |
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The present study examined the clinical utility of the interval to biochemical failure (IBF) as a prognostic factor for distant metastasis (DM) and prostate cancer-specific mortality (PCSM) after radiotherapy. Methods and Materials The study group consisted of 211 T1c-T3Nx-N0M0 patients who had experienced BF among 1,174 men treated with three-dimensional conformal radiotherapy alone. Biochemical failure was defined as a post-treatment prostate-specific antigen (PSA) level of at, or greater than, the PSA nadir plus 2 ng/mL. Cox proportional hazards modeling was used to identify independent predictors of DM and PCSM on multivariate analysis. Results An IBF of <18 months was independently predictive for DM ( p = 0.008), as was a Gleason score of 7–10 ( p = 0.0005), PSA nadir ≥2 ng/mL ( p = 0.04), and decreasing radiation dose ( p = 0.02) on multivariate analysis, including increasing pretreatment PSA level, PSA nadir ≥2.5 ng/mL, PSA doubling time of <3 months, and Stage T3 disease. An IBF of <18 months was the only predictor of PCSM ( p = 0.0003) in the same model. The actuarial 5-year DM rate for an IBF of <18 vs. ≥18 months was 52% vs. 20% ( p < 0.0001), and the actuarial PCSM rate was 36% vs. 6%, respectively ( p = 0.0001). Conclusions The IBF is an important descriptor of the PSA kinetics after radiotherapy to identify men at high risk of clinical failure and death. A IBF of <18 months could aid in selecting men for early, aggressive salvage therapy or participation in a clinical trial.]]></description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2007.05.047</identifier><identifier>PMID: 17919840</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Analysis of Variance ; ANTIGENS ; CARCINOMAS ; CLINICAL TRIALS ; FAILURES ; Hematology, Oncology and Palliative Medicine ; Humans ; Male ; MEN ; METASTASES ; Middle Aged ; MORTALITY ; MULTIVARIATE ANALYSIS ; Neoplasm Staging ; NEOPLASMS ; Prognosis ; Prognostic factor ; Proportional Hazards Models ; PROSTATE ; Prostate cancer ; Prostate-specific antigen ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - radiotherapy ; RADIATION DOSES ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy, Conformal ; Time Factors ; Treatment Failure</subject><ispartof>International journal of radiation oncology, biology, physics, 2008, Vol.70 (1), p.59-66</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-c594b21814db921a99689aa8fdbebfbb301e69b3331c59d269f1cf30ee68afbe3</citedby><cites>FETCH-LOGICAL-c540t-c594b21814db921a99689aa8fdbebfbb301e69b3331c59d269f1cf30ee68afbe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2007.05.047$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3549,4023,27922,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17919840$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21039700$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Buyyounouski, Mark K., M.D., M.S</creatorcontrib><creatorcontrib>Hanlon, Alexandra L., Ph.D</creatorcontrib><creatorcontrib>Horwitz, Eric M., M.D</creatorcontrib><creatorcontrib>Pollack, Alan, M.D., Ph.D</creatorcontrib><title>Interval to Biochemical Failure Highly Prognostic for Distant Metastasis and Prostate Cancer-Specific Mortality After Radiotherapy</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description><![CDATA[Purpose Few biochemical parameters have been related to mortality. The present study examined the clinical utility of the interval to biochemical failure (IBF) as a prognostic factor for distant metastasis (DM) and prostate cancer-specific mortality (PCSM) after radiotherapy. Methods and Materials The study group consisted of 211 T1c-T3Nx-N0M0 patients who had experienced BF among 1,174 men treated with three-dimensional conformal radiotherapy alone. Biochemical failure was defined as a post-treatment prostate-specific antigen (PSA) level of at, or greater than, the PSA nadir plus 2 ng/mL. Cox proportional hazards modeling was used to identify independent predictors of DM and PCSM on multivariate analysis. Results An IBF of <18 months was independently predictive for DM ( p = 0.008), as was a Gleason score of 7–10 ( p = 0.0005), PSA nadir ≥2 ng/mL ( p = 0.04), and decreasing radiation dose ( p = 0.02) on multivariate analysis, including increasing pretreatment PSA level, PSA nadir ≥2.5 ng/mL, PSA doubling time of <3 months, and Stage T3 disease. An IBF of <18 months was the only predictor of PCSM ( p = 0.0003) in the same model. The actuarial 5-year DM rate for an IBF of <18 vs. ≥18 months was 52% vs. 20% ( p < 0.0001), and the actuarial PCSM rate was 36% vs. 6%, respectively ( p = 0.0001). Conclusions The IBF is an important descriptor of the PSA kinetics after radiotherapy to identify men at high risk of clinical failure and death. A IBF of <18 months could aid in selecting men for early, aggressive salvage therapy or participation in a clinical trial.]]></description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>ANTIGENS</subject><subject>CARCINOMAS</subject><subject>CLINICAL TRIALS</subject><subject>FAILURES</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Male</subject><subject>MEN</subject><subject>METASTASES</subject><subject>Middle Aged</subject><subject>MORTALITY</subject><subject>MULTIVARIATE ANALYSIS</subject><subject>Neoplasm Staging</subject><subject>NEOPLASMS</subject><subject>Prognosis</subject><subject>Prognostic factor</subject><subject>Proportional Hazards Models</subject><subject>PROSTATE</subject><subject>Prostate cancer</subject><subject>Prostate-specific antigen</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>RADIATION DOSES</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy, Conformal</subject><subject>Time Factors</subject><subject>Treatment Failure</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkt9r1TAUx4so7jr9D0QCgm-tJ_2V5kWYV-cGG4pT8C2k6elurr1JTdJBX_eXL7UXBF_2kuTA55zD9_tNkrymkFGg9ft9pvfOtmOWA7AMqgxK9iTZ0IbxtKiqX0-TDRQ1pEWET5IX3u8BgFJWPk9OKOOUNyVskvtLE9DdyYEESz5qq3Z40CqW51IPk0NyoW93w0y-OXtrrA9akd468kn7IE0g1xhkfHntiTTdQsUqINlKo9ClNyMq3ceea-uCHHSYyVkf95HvstM27NDJcX6ZPOvl4PHV8T5Nfp5__rG9SK--frncnl2lqiohxJOXbU4bWnYtz6nkvG64lE3ftdj2bRt1Ys3boihoRLu85j1VfQGIdSP7FovT5O06d5EhvNIB1U5ZY1AFkVMoOAOI1LuVGp39M6EP4qC9wmGQBu3kBYt25k3JHgUpr_KK0zyC5Qqq6I532IvR6YN0s6AglijFXqxRiiVKAZWAv_PfHOdP7QG7f03H7CLwYQUwmnan0S2aMPreabdI6qx-bMP_A9SgzZL-b5zR7-3kTAxEUOFzAeJm-U7Lb4LoE2eMFQ8FGMh4</recordid><startdate>2008</startdate><enddate>2008</enddate><creator>Buyyounouski, Mark K., M.D., M.S</creator><creator>Hanlon, Alexandra L., Ph.D</creator><creator>Horwitz, Eric M., M.D</creator><creator>Pollack, Alan, M.D., Ph.D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>2008</creationdate><title>Interval to Biochemical Failure Highly Prognostic for Distant Metastasis and Prostate Cancer-Specific Mortality After Radiotherapy</title><author>Buyyounouski, Mark K., M.D., M.S ; Hanlon, Alexandra L., Ph.D ; Horwitz, Eric M., M.D ; Pollack, Alan, M.D., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-c594b21814db921a99689aa8fdbebfbb301e69b3331c59d269f1cf30ee68afbe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>ANTIGENS</topic><topic>CARCINOMAS</topic><topic>CLINICAL TRIALS</topic><topic>FAILURES</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Male</topic><topic>MEN</topic><topic>METASTASES</topic><topic>Middle Aged</topic><topic>MORTALITY</topic><topic>MULTIVARIATE ANALYSIS</topic><topic>Neoplasm Staging</topic><topic>NEOPLASMS</topic><topic>Prognosis</topic><topic>Prognostic factor</topic><topic>Proportional Hazards Models</topic><topic>PROSTATE</topic><topic>Prostate cancer</topic><topic>Prostate-specific antigen</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>RADIATION DOSES</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy, Conformal</topic><topic>Time Factors</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Buyyounouski, Mark K., M.D., M.S</creatorcontrib><creatorcontrib>Hanlon, Alexandra L., Ph.D</creatorcontrib><creatorcontrib>Horwitz, Eric M., M.D</creatorcontrib><creatorcontrib>Pollack, Alan, M.D., Ph.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Buyyounouski, Mark K., M.D., M.S</au><au>Hanlon, Alexandra L., Ph.D</au><au>Horwitz, Eric M., M.D</au><au>Pollack, Alan, M.D., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interval to Biochemical Failure Highly Prognostic for Distant Metastasis and Prostate Cancer-Specific Mortality After Radiotherapy</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2008</date><risdate>2008</risdate><volume>70</volume><issue>1</issue><spage>59</spage><epage>66</epage><pages>59-66</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract><![CDATA[Purpose Few biochemical parameters have been related to mortality. The present study examined the clinical utility of the interval to biochemical failure (IBF) as a prognostic factor for distant metastasis (DM) and prostate cancer-specific mortality (PCSM) after radiotherapy. Methods and Materials The study group consisted of 211 T1c-T3Nx-N0M0 patients who had experienced BF among 1,174 men treated with three-dimensional conformal radiotherapy alone. Biochemical failure was defined as a post-treatment prostate-specific antigen (PSA) level of at, or greater than, the PSA nadir plus 2 ng/mL. Cox proportional hazards modeling was used to identify independent predictors of DM and PCSM on multivariate analysis. Results An IBF of <18 months was independently predictive for DM ( p = 0.008), as was a Gleason score of 7–10 ( p = 0.0005), PSA nadir ≥2 ng/mL ( p = 0.04), and decreasing radiation dose ( p = 0.02) on multivariate analysis, including increasing pretreatment PSA level, PSA nadir ≥2.5 ng/mL, PSA doubling time of <3 months, and Stage T3 disease. An IBF of <18 months was the only predictor of PCSM ( p = 0.0003) in the same model. The actuarial 5-year DM rate for an IBF of <18 vs. ≥18 months was 52% vs. 20% ( p < 0.0001), and the actuarial PCSM rate was 36% vs. 6%, respectively ( p = 0.0001). Conclusions The IBF is an important descriptor of the PSA kinetics after radiotherapy to identify men at high risk of clinical failure and death. A IBF of <18 months could aid in selecting men for early, aggressive salvage therapy or participation in a clinical trial.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>17919840</pmid><doi>10.1016/j.ijrobp.2007.05.047</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Analysis of Variance ANTIGENS CARCINOMAS CLINICAL TRIALS FAILURES Hematology, Oncology and Palliative Medicine Humans Male MEN METASTASES Middle Aged MORTALITY MULTIVARIATE ANALYSIS Neoplasm Staging NEOPLASMS Prognosis Prognostic factor Proportional Hazards Models PROSTATE Prostate cancer Prostate-specific antigen Prostatic Neoplasms - blood Prostatic Neoplasms - pathology Prostatic Neoplasms - radiotherapy RADIATION DOSES Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy, Conformal Time Factors Treatment Failure |
| title | Interval to Biochemical Failure Highly Prognostic for Distant Metastasis and Prostate Cancer-Specific Mortality After Radiotherapy |
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