Permanent 125I-seed prostate brachytherapy: early prostate specific antigen value as a predictor of PSA bounce occurrence

Abstract

PurposeTo evaluate predictive factors for PSA bounce after 125I permanent seed prostate brachytherapy and identify criteria that distinguish between benign bounces and biochemical relapses.Materials and methodsMen treated with exclusive permanent 125I seed brachytherapy from November 1999, with at least a 36 months follow-up were included. Bounce was defined as an increase ≥ 0.2 ng/ml above the nadir, followed by a spontaneous return to the nadir. Biochemical failure (BF) was defined using the criteria of the Phoenix conference: nadir +2 ng/ml.Results198 men were included. After a median follow-up of 63.9 months, 21 patients experienced a BF, and 35.9% had at least one bounce which occurred after a median period of 17 months after implantation (4-50). Bounce amplitude was 0.6 ng/ml (0.2-5.1), and duration was 13.6 months (4.0-44.9). In 12.5%, bounce magnitude exceeded the threshold defining BF. Age at the time of treatment and high PSA level assessed at 6 weeks were significantly correlated with bounce but not with BF. Bounce patients had a higher BF free survival than the others (100% versus 92%, p = 0,007). In case of PSA increase, PSA doubling time and velocity were not significantly different between bounce and BF patients. Bounces occurred significantly earlier than relapses and than nadir + 0.2 ng/ml in BF patients (17 vs 27.8 months, p < 0.0001).ConclusionHigh PSA value assessed 6 weeks after brachytherapy and young age were significantly associated to a higher risk of bounces but not to BF. Long delays between brachytherapy and PSA increase are more indicative of BF.

Analysis of postoperative PSA changes after ultrasound-guided permanent [125I] seed implantation for the treatment of prostate cancer

“…However, in group B (biochemical relapse group), the initial PSA rise after the nadir occurred postoperatively at 30.2 ± 2.1 months, and there was a statistically significant difference between the 2 groups (P < 0.01). This is consistent with the results of Mazeron et al (2012) where the follow-up of 198 prostate cancer patients who underwent […”

Current Approaches, Challenges and Future Directions for Monitoring Treatment Response in Prostate Cancer

“…The effect of experiencing a bounce predicted for an increased risk of biochemical failure by approximately 14% (58% vs. 72%) at 10 years 88. This is not the case in other reported analysis in which the bounce phenomenon was associated with improved biochemical outcomes 103.…”

Prostate-Specific Antigen Dynamics After Carbon Ion Radiotherapy for Prostate Cancer

“…Multiple de nitions of the PSA bounce have been reported, and no consensus has been established. Several studies used the de nition of an increase of >0.2 ng/ml in PSA levels followed by a spontaneous decrease to the pre-bounce level or lower [14,17,21,[28][29]. In the present study, no patient met this de nition, as the nadir PSA level was extremely low because of the use of neoadjuvant ADT.…”