PSA decay during salvage radiotherapy for prostate cancer as a predictor of disease outcome – 5 year follow-up of a prospective observational study
Gunnlaugsson, Adalsteinn LU ; Kjellén, Elisabeth LU ; Bratt, Ola LU ; Ahlgren, Göran LU ; Johannesson, Vilberg LU ; Blom, René LU and Nilsson, Per LU
(2020)
In Clinical and Translational Radiation Oncology
24.
p.23-28
- Abstract
- Background and purpose: Biochemical recurrence after prostatectomy is commonly treated with salvage radiotherapy (SRT). In this prospective observational study we investigated the PSA decay rate, determined by predefined serial PSA measurements during SRT, as a predictor for treatment outcome.
Materials and methods: Between 2013 and 2016, 214 patients were included in the study. The prescribed dose to the prostate bed was 70 Gy in 35 fractions (7 weeks) without hormonal treatment. PSA was measured weekly during SRT. Assuming first order kinetics, a PSA decay-rate constant (k) was calculated for 196 eligible patients. The ability of k to predict disease progression was compared with known clinical prediction parameters using Cox... (More) - Background and purpose: Biochemical recurrence after prostatectomy is commonly treated with salvage radiotherapy (SRT). In this prospective observational study we investigated the PSA decay rate, determined by predefined serial PSA measurements during SRT, as a predictor for treatment outcome.
Materials and methods: Between 2013 and 2016, 214 patients were included in the study. The prescribed dose to the prostate bed was 70 Gy in 35 fractions (7 weeks) without hormonal treatment. PSA was measured weekly during SRT. Assuming first order kinetics, a PSA decay-rate constant (k) was calculated for 196 eligible patients. The ability of k to predict disease progression was compared with known clinical prediction parameters using Cox regression, logistic regression and ROC analyses. Disease progression was defined as continuously rising PSA after SRT, PSA increase by ≥0.2 ng/ml above nadir after SRT, hormonal treatment or clinical progression.
Results: After a median follow up of 4.7 years the estimated failure-free survival at 5 years was 56%. The PSA decay-rate constant (k) was found to be the strongest predictor of disease progression in both uni-and multivariable analyses.
Conclusion: The addition of k to established clinical variables significantly improves the possibility to predict treatment outcome after SRT and could be used to personalize future therapies.
(Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/5e251b07-33c5-4872-ad98-7258fe3b22ef
- author
- Gunnlaugsson, Adalsteinn
LU
; Kjellén, Elisabeth
LU
; Bratt, Ola
LU
; Ahlgren, Göran
LU
; Johannesson, Vilberg
LU
; Blom, René
LU
and Nilsson, Per
LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Clinical and Translational Radiation Oncology
- volume
- 24
- pages
- 23 - 28
- publisher
- Elsevier
- external identifiers
-
- pmid:32613088
- scopus:85086655196
- ISSN
- 2405-6308
- DOI
- 10.1016/j.ctro.2020.05.008
- language
- English
- LU publication?
- yes
- id
- 5e251b07-33c5-4872-ad98-7258fe3b22ef
- date added to LUP
- 2020-07-03 09:30:01
- date last changed
- 2022-04-18 23:25:48
@article{5e251b07-33c5-4872-ad98-7258fe3b22ef,
abstract = {{Background and purpose: Biochemical recurrence after prostatectomy is commonly treated with salvage radiotherapy (SRT). In this prospective observational study we investigated the PSA decay rate, determined by predefined serial PSA measurements during SRT, as a predictor for treatment outcome.<br/><br/>Materials and methods: Between 2013 and 2016, 214 patients were included in the study. The prescribed dose to the prostate bed was 70 Gy in 35 fractions (7 weeks) without hormonal treatment. PSA was measured weekly during SRT. Assuming first order kinetics, a PSA decay-rate constant (k) was calculated for 196 eligible patients. The ability of k to predict disease progression was compared with known clinical prediction parameters using Cox regression, logistic regression and ROC analyses. Disease progression was defined as continuously rising PSA after SRT, PSA increase by ≥0.2 ng/ml above nadir after SRT, hormonal treatment or clinical progression.<br/><br/>Results: After a median follow up of 4.7 years the estimated failure-free survival at 5 years was 56%. The PSA decay-rate constant (k) was found to be the strongest predictor of disease progression in both uni-and multivariable analyses.<br/><br/>Conclusion: The addition of k to established clinical variables significantly improves the possibility to predict treatment outcome after SRT and could be used to personalize future therapies.<br/>}},
author = {{Gunnlaugsson, Adalsteinn and Kjellén, Elisabeth and Bratt, Ola and Ahlgren, Göran and Johannesson, Vilberg and Blom, René and Nilsson, Per}},
issn = {{2405-6308}},
language = {{eng}},
pages = {{23--28}},
publisher = {{Elsevier}},
series = {{Clinical and Translational Radiation Oncology}},
title = {{PSA decay during salvage radiotherapy for prostate cancer as a predictor of disease outcome – 5 year follow-up of a prospective observational study}},
url = {{http://dx.doi.org/10.1016/j.ctro.2020.05.008}},
doi = {{10.1016/j.ctro.2020.05.008}},
volume = {{24}},
year = {{2020}},
}