Clinical features of prostate-specific antigen bounce after 125I brachytherapy for prostate cancer

Abstract

The aim of this study was to analyse the clinical features of prostate-specific antigen (PSA) bounce and the difference between biochemical failure and large-magnitude PSA bounce. The cases of 352 patients with prostate cancer who underwent brachytherapy were analysed. PSA bounce was defined as an increase in PSA of ≥0.2 ng/ml above an initial PSA nadir, with subsequent decline to or below that initial nadir without treatment. PSA bounce +2 was defined as an increase in PSA of ≥2.0 ng/ml above the nadir with subsequent decline to or below that initial nadir without treatment. We analysed the rates, time to onset, and predictive factors for PSA bounce and PSA bounce +2. The median follow-up period at the time of evaluation was 82 months. One hundred and seventeen patients had PSA bounce; of them, 10 had PSA bounce +2. Biochemical failure occurred in 29 patients. The median times to onset of PSA bounce, PSA bounce +2, and biochemical failure were 20, 17.5 and 51 months, respectively. Younger age at implant and larger prostate volume were significant predictive factors for PSA bounce. Age was a significant factor for PSA bounce +2, and PSA bounce +2 patients were significantly younger than biochemical failure patients. The maximum duration from the date of PSA bounce +2 to the date when PSA level decreased was 12 months. Age at implant, time to onset, and 1-year follow-up after an increase in PSA level of ≥2 ng/ml above nadir level are useful for distinguishing between biochemical failure and PSA bounce +2.

Characteristics of PSA Bounce after Radiotherapy for Prostate Cancer: A Meta-Analysis

“…A systematic literature review was performed to identify studies reporting PSA bounce post-radiotherapy (see Materials and Methods for details) ( Figure 1 ). The search identified 50 studies including 26,258 patients, which were included in the analysis ( Table 1 ) [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. The number of studies and patients stratified by modality is summarized in Table S1 .…”

“…The number of studies and patients stratified by modality is summarized in Table S1. Among the 50 studies, eight were prospective observational studies [14,15,17,32,[39][40][41]50] and the others were retrospective observational studies. A meta-analysis showed that the rate of PSA bounce for all studies was 31% (95% confidence interval (CI), 28-33%) (Figure 2).…”

Case – Prostate-specific antigen bounce: A pitfall in prostate-specific membrane antigen positron emission tomography/computed tomography interpretation

“…Prostate-specific antigen (PSA) "bounce," a transient rise in PSA post-therapy, can happen after either brachytherapy (BT) or external beam radiation therapy (EBRT); however, it is more common in the former case (1,2). In general, PSA bounce tends to occur within 2-3 years of treatment, rarely exceeds levels of 2-3ng/ml above the nadir PSA and tends to resolve over 6-12 months (2).…”

“…Prostate-specific antigen (PSA) "bounce," a transient rise in PSA post-therapy, can happen after either brachytherapy (BT) or external beam radiation therapy (EBRT); however, it is more common in the former case (1,2). In general, PSA bounce tends to occur within 2-3 years of treatment, rarely exceeds levels of 2-3ng/ml above the nadir PSA and tends to resolve over 6-12 months (2). Studies have shown that PSMA PET/CT (Prostate-specific membrane antigen positron emission tomography/Computational Tomography) has a high sensitivity and specificity for the detection of prostate cancer recurrence and can potentially guide therapy (3).…”

Hydrogel spacer shrinkage during external-beam radiation therapy following low-dose-rate brachytherapy for high-risk prostate cancer: a case series

“…Patients with high-risk disease received ADT and BT followed by EBRT. Our implant procedure was previously described in detail [ 9 ]. We implanted the 125 I sources using a modified peripheral loading pattern for seed placement.…”