The PSA nadir that indicates potential cure after radiotherapy for prostate cancer.
Urology
; 49(3): 322-6, 1997 Mar.
Article
en En
| MEDLINE
| ID: mdl-9123692
ABSTRACT
OBJECTIVES:
The prostate-specific antigen nadir that indicates potential cure by radiotherapy has never been established. We determined this nadir level and used it to define precisely disease freedom after radiotherapy.METHODS:
Combination radioactive 125I prostate implant followed by external-beam radiation was administered to 660 men with clinical Stage T1T2N0 prostate cancer. The average pretreatment prostate-specific antigen level (Tandem R Assay) was 11.7 ng/mL (median 8.0 ng/mL, range 0.3 to 188 ng/mL). To analyze these data, recurrence was defined as a prostate-specific antigen level rising above whatever nadir was achieved. The median follow-up is 42 months (range 12 to 150 months).RESULTS:
Eighty-one percent of all men are calculated to achieve a prostate-specific antigen nadir of 0.5 ng/mL or less and to have a 5- and 10-year disease-free survival rate of 93% and 83%, respectively, as compared with a 5-year disease-free survival rate of 26% for those achieving a nadir of 0.6 to 1.0 ng/mL--a significant difference (P = 0.0001). All men with a nadir greater than 1.0 ng/mL ultimately failed treatment. Of 201 men with a minimum 5-year follow-up, 143 are disease-free and 140 (98%) achieved and maintained a nadir of 0.5 ng/mL or less.CONCLUSIONS:
For possible cure of prostate cancer with radiotherapy, a prostate-specific antigen nadir of 0.5 ng/mL or less should be achieved. With this nadir level, disease freedom after irradiation is defined as achievement and maintenance of a nadir of 0.5 ng/mL or less. A nadir greater than 0.5 ng/mL or subsequent increase above 0.5 ng/mL is defined as irradiation treatment failure. This definition may help resolve the controversy about the potential for cure of prostate cancer by irradiation.
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Bases de datos:
MEDLINE
Asunto principal:
Neoplasias de la Próstata
/
Antígeno Prostático Específico
/
Radioisótopos de Yodo
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Humans
/
Male
Idioma:
En
Revista:
Urology
Año:
1997
Tipo del documento:
Article
País de afiliación:
Estados Unidos