The impact of timing of salvage hormonal therapy on survival after brachytherapy for prostate cancer

Sagalovich, Daniel; Leapman, Michael; Sfakianos, John P.; Hall, Simon; Stock, Richard G.; Stone, Nelson N.

doi:10.1016/j.brachy.2016.09.005

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…In this study, the median duration from the date of PSA bounce +2 to the date when the PSA level decreased was 4.5 months, while the maximum duration was 1 year. Sagalovich et al evaluated the impact of timing of androgen deprivation therapy on survival in a cohort of patients with biochemical failure after BT for prostate cancer [ 19 ], but identified no significant difference in survival between immediate and delayed salvage hormonal therapy. The median delay till salvage androgen deprivation therapy in their study was 19 months.…”

Section: Discussionmentioning

confidence: 99%

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

Kubo

Wadasaki

Kimura

et al. 2018

Journal of Radiation Research

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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.

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Section: Discussionmentioning

confidence: 99%

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

Kubo

Wadasaki

Kimura

et al. 2018

Journal of Radiation Research

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Prognostic Value of Biochemical Recurrence Following Treatment with Curative Intent for Prostate Cancer: A Systematic Review

et al. 2019

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Context. In men with prostate cancer (PCa) treated with curative intent, controversy exists regarding the impact of biochemical recurrence (BCR) on oncological patient outcomes. Objective. To perform a systematic review of the existing literature on BCR after treatment with curative intent for non-metastatic PCa. Objective 1 is to investigate whether oncological outcomes differ between patients with or without BCR. Objective 2 is to study which clinical factors and tumor features in patients with BCR have an independent prognostic impact on oncological outcomes. Evidence acquisition. Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched. For objective 1, prospective and retrospective studies comparing survival outcomes of patients with or without BCR following radical prostatectomy (RP) or radical radiotherapy (RT) were included. For objective 2, all studies with at least 100 participants and reporting on prognostic features in patients with BCR were included. Risk-of-bias and confounding assessments were performed according to the Quality in Prognosis Studies (QUIPS) tool. Both a narrative synthesis and meta-analysis were undertaken. Evidence synthesis. Overall, 77 studies were included for analysis, of which 14 studies addressed objective 1, recruiting 20406 patients. Objective 2 was addressed by 71 studies with 29057, 11301 and 4272 patients undergoing RP, RT or a mixed population (mix of patients undergoing RP or RT as primary treatment) respectively. There was low risk of bias for study participation, confounders and statistical analysis. For most studies, attrition bias, prognostic and outcome measurements were not clearly reported. BCR was associated with worse survival rates, mainly in patients with a short PSA Doubling Time (PSA-DT) and high final Gleason score after RP or a short Interval to Biochemical Failure (IBF) after RT and high biopsy Gleason score. Conclusion. BCR has an impact on survival, but this effect appears to be limited to a subgroup of patients with specific clinical risk factors. A short PSA-DT and high final Gleason score after RP and a short IBF after RT and high biopsy Gleason score are the main factors which have a negative impact on survival. Patient summary. This review looks at the risk of dying in men who have a rising PSA blood test after curative surgery or radiotherapy. For many men a rising PSA does not mean they are at a higher risk of dying from prostate cancer in the longer term. Men with a PSA that rises shortly after they were treated with radiotherapy or a rapidly rising PSA after surgery and a high tumor-grade for both treatment modalities are at the highest risk of dying.

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The impact of timing of salvage hormonal therapy on survival after brachytherapy for prostate cancer

Cited by 2 publications

References 25 publications

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

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

Prognostic Value of Biochemical Recurrence Following Treatment with Curative Intent for Prostate Cancer: A Systematic Review

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