Prostate-specific antigen kinetics following external-beam radiotherapy and temporary (Ir-192) or permanent (I-125) brachytherapy for prostate cancer
Abstract Background and purpose The aim of the study was the evaluation of PSA kinetics after different radiotherapy methods. Materials and methods Two-hundred and ninety five patients received external-beam radiotherapy (EBRT; 70.2 Gy; n = 135), Ir-192 brachytherapy as a boost to EBRT (HDR-BT; 18 G...
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| Veröffentlicht in: | Radiotherapy and oncology 2010-07, Vol.96 (1), p.25-29 |
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| creator | Pinkawa, Michael Piroth, Marc D Holy, Richard Fischedick, Karin Schaar, Sandra Borchers, Holger Heidenreich, Axel Eble, Michael J |
| description | Abstract Background and purpose The aim of the study was the evaluation of PSA kinetics after different radiotherapy methods. Materials and methods Two-hundred and ninety five patients received external-beam radiotherapy (EBRT; 70.2 Gy; n = 135), Ir-192 brachytherapy as a boost to EBRT (HDR-BT; 18 Gy + 50.4 Gy; n = 66) or I-125 brachytherapy (LDR-BT; 145 Gy; n = 94) as monotherapy. “PSA bounce” was defined as a PSA rise of ⩾0.2 ng/ml followed by spontaneous return to prebounce level or lower, biochemical failure as “nadir + 2 ng/ml”. Results Patients without biochemical failure reached a lower nadir after brachytherapy (median ⩽0.05 ng/ml after LDR- and HDR-BT without NHT) in comparison to EBRT (0.55 ng/ml without NHT; p < 0.01). Not a single patient without NHT and a nadir |
| doi_str_mv | 10.1016/j.radonc.2010.02.010 |
| format | Article |
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Materials and methods Two-hundred and ninety five patients received external-beam radiotherapy (EBRT; 70.2 Gy; n = 135), Ir-192 brachytherapy as a boost to EBRT (HDR-BT; 18 Gy + 50.4 Gy; n = 66) or I-125 brachytherapy (LDR-BT; 145 Gy; n = 94) as monotherapy. “PSA bounce” was defined as a PSA rise of ⩾0.2 ng/ml followed by spontaneous return to prebounce level or lower, biochemical failure as “nadir + 2 ng/ml”. Results Patients without biochemical failure reached a lower nadir after brachytherapy (median ⩽0.05 ng/ml after LDR- and HDR-BT without NHT) in comparison to EBRT (0.55 ng/ml without NHT; p < 0.01). Not a single patient without NHT and a nadir <0.1 ng/ml failed biochemically (0% vs. 45% with a nadir ⩾0.1 ng/ml; p < 0.01). PSA bounces were found predominantly in the LDR-BT group (42% vs. 23%/20% after HDR-BT/EBRT; p < 0.01). In a multivariate Cox regression analysis, LDR-BT and HDR-BT were associated with a significantly lower biochemical failure rate in comparison to EBRT. Conclusions PSA kinetics differ significantly following different radiotherapy methods. A lower nadir and a higher biochemical control rate suggest a higher radiobiological efficiency of brachytherapy in comparison to EBRT (with a dose of 70.2 Gy).</description><identifier>ISSN: 0167-8140</identifier><identifier>EISSN: 1879-0887</identifier><identifier>DOI: 10.1016/j.radonc.2010.02.010</identifier><identifier>PMID: 20231039</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Adenocarcinoma - blood ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - radiotherapy ; Aged ; Aged, 80 and over ; Brachytherapy ; Brachytherapy - methods ; Chi-Square Distribution ; Cohort Studies ; Confidence Intervals ; Dose-Response Relationship, Radiation ; Follow-Up Studies ; Hematology, Oncology and Palliative Medicine ; Hormone therapy ; Humans ; I-125 ; Ir-192 ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; Prostate cancer ; Prostate-specific antigen ; Prostate-Specific Antigen - pharmacokinetics ; Prostate-Specific Antigen - radiation effects ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - mortality ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - radiotherapy ; Radiotherapy ; Radiotherapy Dosage ; Radiotherapy, High-Energy - methods ; Risk Assessment ; Survival Rate ; Time Factors ; Treatment Outcome</subject><ispartof>Radiotherapy and oncology, 2010-07, Vol.96 (1), p.25-29</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2010 Elsevier Ireland Ltd</rights><rights>Copyright 2010 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-70269fe46cbe932b5bb25129e9d17d5a3035995a2c9e5287c80653b1bb7b08ea3</citedby><cites>FETCH-LOGICAL-c482t-70269fe46cbe932b5bb25129e9d17d5a3035995a2c9e5287c80653b1bb7b08ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.radonc.2010.02.010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20231039$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pinkawa, Michael</creatorcontrib><creatorcontrib>Piroth, Marc D</creatorcontrib><creatorcontrib>Holy, Richard</creatorcontrib><creatorcontrib>Fischedick, Karin</creatorcontrib><creatorcontrib>Schaar, Sandra</creatorcontrib><creatorcontrib>Borchers, Holger</creatorcontrib><creatorcontrib>Heidenreich, Axel</creatorcontrib><creatorcontrib>Eble, Michael J</creatorcontrib><title>Prostate-specific antigen kinetics following external-beam radiotherapy and temporary (Ir-192) or permanent (I-125) brachytherapy for prostate cancer</title><title>Radiotherapy and oncology</title><addtitle>Radiother Oncol</addtitle><description>Abstract Background and purpose The aim of the study was the evaluation of PSA kinetics after different radiotherapy methods. Materials and methods Two-hundred and ninety five patients received external-beam radiotherapy (EBRT; 70.2 Gy; n = 135), Ir-192 brachytherapy as a boost to EBRT (HDR-BT; 18 Gy + 50.4 Gy; n = 66) or I-125 brachytherapy (LDR-BT; 145 Gy; n = 94) as monotherapy. “PSA bounce” was defined as a PSA rise of ⩾0.2 ng/ml followed by spontaneous return to prebounce level or lower, biochemical failure as “nadir + 2 ng/ml”. Results Patients without biochemical failure reached a lower nadir after brachytherapy (median ⩽0.05 ng/ml after LDR- and HDR-BT without NHT) in comparison to EBRT (0.55 ng/ml without NHT; p < 0.01). Not a single patient without NHT and a nadir <0.1 ng/ml failed biochemically (0% vs. 45% with a nadir ⩾0.1 ng/ml; p < 0.01). PSA bounces were found predominantly in the LDR-BT group (42% vs. 23%/20% after HDR-BT/EBRT; p < 0.01). In a multivariate Cox regression analysis, LDR-BT and HDR-BT were associated with a significantly lower biochemical failure rate in comparison to EBRT. Conclusions PSA kinetics differ significantly following different radiotherapy methods. A lower nadir and a higher biochemical control rate suggest a higher radiobiological efficiency of brachytherapy in comparison to EBRT (with a dose of 70.2 Gy).</description><subject>Adenocarcinoma - blood</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - radiotherapy</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brachytherapy</subject><subject>Brachytherapy - methods</subject><subject>Chi-Square Distribution</subject><subject>Cohort Studies</subject><subject>Confidence Intervals</subject><subject>Dose-Response Relationship, Radiation</subject><subject>Follow-Up Studies</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Hormone therapy</subject><subject>Humans</subject><subject>I-125</subject><subject>Ir-192</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Proportional Hazards Models</subject><subject>Prostate cancer</subject><subject>Prostate-specific antigen</subject><subject>Prostate-Specific Antigen - pharmacokinetics</subject><subject>Prostate-Specific Antigen - radiation effects</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - mortality</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radiotherapy</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, High-Energy - methods</subject><subject>Risk Assessment</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0167-8140</issn><issn>1879-0887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUstuFDEQtBCILIE_QMg3yGEWP9bj8QUpigJEigQScLZsT0_izYw92F5gPyT_i4fdcODCqaVWVVd1VyP0kpI1JbR9u10n08fg1ozUFmHrWh6hFe2kakjXycdoVWGy6eiGnKBnOW8JIYxw-RSdMMI4JVyt0P3nFHMxBZo8g_ODd9iE4m8g4DsfoHiX8RDHMf704QbDrwIpmLGxYCZc9X0st5DMvK-sHheY5phM2uM3V6mhip3hmPAMaTIBQqndhjJxhm0y7nb_wBwWzNEFdiY4SM_Rk8GMGV4c6yn69v7y68XH5vrTh6uL8-vGbTpWGklYqwbYtM6C4swKa5mgTIHqqeyF4YQLpYRhToFgnXQdaQW31FppSQeGn6LXh7lV__sOctGTzw7GsfqNu6wl560QQomK3ByQrjrNCQY9Jz_VVTUleslDb_UhD73koQnTtVTaq6PAzk7Q_yU9BFAB7w4AqGv-8JB0dh7qDXqfwBXdR_8_hX8HuNEH78x4B3vI27hbAsua6lwJ-svyE8tL0PoNfxz8Bjs5s7Y</recordid><startdate>20100701</startdate><enddate>20100701</enddate><creator>Pinkawa, Michael</creator><creator>Piroth, Marc D</creator><creator>Holy, Richard</creator><creator>Fischedick, Karin</creator><creator>Schaar, Sandra</creator><creator>Borchers, Holger</creator><creator>Heidenreich, Axel</creator><creator>Eble, Michael J</creator><general>Elsevier Ireland Ltd</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>7X8</scope></search><sort><creationdate>20100701</creationdate><title>Prostate-specific antigen kinetics following external-beam radiotherapy and temporary (Ir-192) or permanent (I-125) brachytherapy for prostate cancer</title><author>Pinkawa, Michael ; Piroth, Marc D ; Holy, Richard ; Fischedick, Karin ; Schaar, Sandra ; Borchers, Holger ; Heidenreich, Axel ; Eble, Michael J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-70269fe46cbe932b5bb25129e9d17d5a3035995a2c9e5287c80653b1bb7b08ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adenocarcinoma - blood</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - radiotherapy</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brachytherapy</topic><topic>Brachytherapy - methods</topic><topic>Chi-Square Distribution</topic><topic>Cohort Studies</topic><topic>Confidence Intervals</topic><topic>Dose-Response Relationship, Radiation</topic><topic>Follow-Up Studies</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Hormone therapy</topic><topic>Humans</topic><topic>I-125</topic><topic>Ir-192</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Proportional Hazards Models</topic><topic>Prostate cancer</topic><topic>Prostate-specific antigen</topic><topic>Prostate-Specific Antigen - pharmacokinetics</topic><topic>Prostate-Specific Antigen - radiation effects</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - mortality</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radiotherapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, High-Energy - methods</topic><topic>Risk Assessment</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pinkawa, Michael</creatorcontrib><creatorcontrib>Piroth, Marc D</creatorcontrib><creatorcontrib>Holy, Richard</creatorcontrib><creatorcontrib>Fischedick, Karin</creatorcontrib><creatorcontrib>Schaar, Sandra</creatorcontrib><creatorcontrib>Borchers, Holger</creatorcontrib><creatorcontrib>Heidenreich, Axel</creatorcontrib><creatorcontrib>Eble, Michael J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Radiotherapy and oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pinkawa, Michael</au><au>Piroth, Marc D</au><au>Holy, Richard</au><au>Fischedick, Karin</au><au>Schaar, Sandra</au><au>Borchers, Holger</au><au>Heidenreich, Axel</au><au>Eble, Michael J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prostate-specific antigen kinetics following external-beam radiotherapy and temporary (Ir-192) or permanent (I-125) brachytherapy for prostate cancer</atitle><jtitle>Radiotherapy and oncology</jtitle><addtitle>Radiother Oncol</addtitle><date>2010-07-01</date><risdate>2010</risdate><volume>96</volume><issue>1</issue><spage>25</spage><epage>29</epage><pages>25-29</pages><issn>0167-8140</issn><eissn>1879-0887</eissn><abstract>Abstract Background and purpose The aim of the study was the evaluation of PSA kinetics after different radiotherapy methods. Materials and methods Two-hundred and ninety five patients received external-beam radiotherapy (EBRT; 70.2 Gy; n = 135), Ir-192 brachytherapy as a boost to EBRT (HDR-BT; 18 Gy + 50.4 Gy; n = 66) or I-125 brachytherapy (LDR-BT; 145 Gy; n = 94) as monotherapy. “PSA bounce” was defined as a PSA rise of ⩾0.2 ng/ml followed by spontaneous return to prebounce level or lower, biochemical failure as “nadir + 2 ng/ml”. Results Patients without biochemical failure reached a lower nadir after brachytherapy (median ⩽0.05 ng/ml after LDR- and HDR-BT without NHT) in comparison to EBRT (0.55 ng/ml without NHT; p < 0.01). Not a single patient without NHT and a nadir <0.1 ng/ml failed biochemically (0% vs. 45% with a nadir ⩾0.1 ng/ml; p < 0.01). PSA bounces were found predominantly in the LDR-BT group (42% vs. 23%/20% after HDR-BT/EBRT; p < 0.01). In a multivariate Cox regression analysis, LDR-BT and HDR-BT were associated with a significantly lower biochemical failure rate in comparison to EBRT. Conclusions PSA kinetics differ significantly following different radiotherapy methods. A lower nadir and a higher biochemical control rate suggest a higher radiobiological efficiency of brachytherapy in comparison to EBRT (with a dose of 70.2 Gy).</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>20231039</pmid><doi>10.1016/j.radonc.2010.02.010</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adenocarcinoma - blood Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - radiotherapy Aged Aged, 80 and over Brachytherapy Brachytherapy - methods Chi-Square Distribution Cohort Studies Confidence Intervals Dose-Response Relationship, Radiation Follow-Up Studies Hematology, Oncology and Palliative Medicine Hormone therapy Humans I-125 Ir-192 Kaplan-Meier Estimate Male Middle Aged Neoplasm Staging Proportional Hazards Models Prostate cancer Prostate-specific antigen Prostate-Specific Antigen - pharmacokinetics Prostate-Specific Antigen - radiation effects Prostatic Neoplasms - blood Prostatic Neoplasms - mortality Prostatic Neoplasms - pathology Prostatic Neoplasms - radiotherapy Radiotherapy Radiotherapy Dosage Radiotherapy, High-Energy - methods Risk Assessment Survival Rate Time Factors Treatment Outcome |
| title | Prostate-specific antigen kinetics following external-beam radiotherapy and temporary (Ir-192) or permanent (I-125) brachytherapy for prostate cancer |
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