Prostate-specific antigen bounce after 125I-brachytherapy for prostate cancer is a favorable prognosticator in patients who are biochemical recurrence-free at 4 years and correlates with testosterone. (28th October 2019)

• Record Type: Journal Article
• Authors: Nakai, Yasushi; Tanaka, Nobumichi; Asakawa, Isao; Anai, Satoshi; Miyake, Makito; Morizawa, Yosuke; Hori, Shunta; Owari, Takuya; Fujii, Tomomi; Yamaki, Kaori; Hasegawa, Masatoshi; Fujimoto, Kiyohide
• Is Part Of: Japanese journal of clinical oncology. Volume 50:Number 1(2020)
• Page Start: 58
• Page End: 65
• Publication Date: 2019-10-28
• Subjects: prostate-specific antigen bounce -- testosterone -- prostate cancer -- brachytherapy; Oncology -- Periodicals; Cancer -- Periodicals; 616.994005
• DOI: 10.1093/jjco/hyz136
• Languages: English
• ISSNs: 0368-2811

Abstract

Abstract: Background: Because patients with prostate-specific antigen (PSA) bounce do not experience biochemical recurrence (BCR) until PSA bounce occurs, the period until PSA bounce ends can be considered the so-called lead-time bias. Therefore, we evaluated differences in BCR-free rate in prostate cancer patients who were BCR-free 4 years after 125 I-brachytherapy alone. Furthermore, we evaluated predictors for PSA bounce and the correlation between testosterone and PSA bounce. Methods: From 2004 to 2012, 256 patients with prostate adenocarcinoma underwent 125 I-brachytherapy alone. PSA and testosterone levels were monitored prior to 125 I-brachytherapy, at 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54 and 60 months after 125 I-brachytherapy and yearly after 5-year follow-up. PSA bounce was defined as ≥0.2 ng/ml increase above the interval PSA nadir, followed by a decrease to nadir or below. Results: BCR-free rate in patients with PSA bounce (100% 7-year BCR-free rate) was significantly better ( P < 0.044) than that in patients without PSA bounce (95.7% 7-year BCR-free rate) in patients who were BCR-free 4 years after 125 I-brachytherapy alone ( n = 223). Age was the only predictor (odds ratio: 0.93, 95% confidence interval: 0.88–0.98, P = 0.004) for PSA bounce ( n = 177). The testosterone level at PSA bounce was significantly higher ( P = 0.036) than that at nadir before PSA bounce (87 cases). Conclusions: Patients with PSA bounce had good BCR-free rate even in patients who were BCR-free 4 years after 125 I-brachytherapy alone. Testosterone levels were higher at PSA bounce; increased testosterone levels may be a cause of PSA bounce.