Time to Achieve a Prostate Specific Antigen Nadir of 0.2 Ng./ml. After Simultaneous Irradiation For Prostate Cancer

Field: Medicine (Health Sciences)

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Dec 2002Time to Achieve a Prostate Specific Antigen Nadir of 0.2 Ng./ml. After Simultaneous Irradiation For Prostate Cancer FRANK A. CRITZ FRANK A. CRITZFRANK A. CRITZ View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64162-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A prostate specific antigen (PSA) cutoff point of 0.2 ng./ml. has been suggested as the standard definition of disease freedom for curative treatment of localized prostate cancer. The time to achieve this goal after irradiation was determined in this study. Materials and Methods: From August 1992 to December 1996, 539 consecutive men with clinical stage T1T2NX prostate cancer who had a minimum 5-year PSA followup and achieved a PSA nadir of 0.2 ng./ml. without hormones were evaluated. All patients were treated with simultaneous irradiation with a transperineal prostate 125iodine implant, followed by external beam irradiation. Time to achieve a PSA of 0.2 ng./ml. was retrospectively calculated from the date of implantation in all men and according to various factors. Recurrence was defined as a subsequent increase above a PSA of 0.2 ng./ml. Minimum followup was 5 years (median 6.5, range 5 to 9). Results: In all 539 men the median time to a PSA nadir of 0.2 ng./ml. was 27 months, while 534 (99%) achieved this level by 60 months of followup. Median time to achieve this PSA goal was 20 and 39 months in patients without and with a PSA bounce, respectively. Pretreatment PSA, disease status and ultimately PSA bounce, Gleason score and stage had little or no effect on time to a PSA of 0.2 ng./ml. Conclusions: With rare exceptions to be potentially cured of prostate cancer by simultaneous irradiation men must achieve a PSA nadir of 0.2 ng./ml. within 5 years of implantation. Failure to reach this goal by 60 months of followup almost always indicates persistent disease. References 1 : Defining prostate specific antigen progression after radical prostatectomy: what is the most appropriate cut point?. J Urol2001; 165: 1146. Link, Google Scholar 2 : A standard definition of disease freedom is needed for prostate cancer: undetectable prostate specific antigen compared with the American Society of Therapeutic Radiology and Oncology consensus definition. J Urol2002; 167: 1310. Link, Google Scholar 3 : The correlation of serial prostate specific antigen measurements with clinical outcome after external beam radiation therapy of patients for prostate cancer. Cancer2000; 88: 2305. 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Volume 168Issue 6December 2002Page: 2434-2438 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsradiotherapyprostatic neoplasmsprostate-specific antigenprostateMetricsAuthor Information FRANK A. CRITZ More articles by this author Expand All Advertisement PDF downloadLoading ...