The Importance of Prostate-specific Antigen (PSA) Nadir and Early Identification of PSA Relapse after 10 Years of Prostate Iodine125 Seed Brachytherapy in Edinburgh

D. B. McLaren*, G. Kerr, A. B. Law, J. P. Brush, J. Keanie, J. Malik, W. Keough, T. Ronaldson, J. Lee, T. Kehoe

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To analyse our 5 and 10 year prostate brachytherapy outcome data and to assess the impact of PSA nadir on relapse free survival and whether an alternative definition of PSA relapse could detect men destined to fail by the Phoenix definition at an earlier time point. Materials and methods: 474 men were treated over a 10 year period between 20012 and 2011and divided into 2 five year cohorts for the purpose of the analysis. Results: The risk of relapse is strongly predicted by post treat prostate-specific antigen (PSA) nadir. After 3 years post-treatment, PSA nadir plus 0.4ng/ml identified men at risk of relapse 17 months earlier than the Phoenix definition. Conclusion: The Phoenix definition of nadir plus 2.0ng/ml does not allow the early identification of men destined to relapse. The initiation of salavage therapy at the earliest opportunity could potentially affect subsequent survival and an outline randomised controlled trial proposal is presented.

Original languageEnglish
Pages (from-to)519-526
Number of pages8
JournalClinical Oncology
Volume27
Issue number9
DOIs
Publication statusPublished - 1 Sep 2015

Keywords

  • Iodine seed brachytherapy
  • Prostate cancer
  • PSA nadir
  • Relapse
  • Salvage treatment

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