Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Mar 26:7:46.
doi: 10.1186/1748-717X-7-46.

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

Renaud Mazeron  1 , Agathe Bajard, Xavier Montbarbon, Frédéric Gassa, Claude Malet, François Rocher, Sébastien Clippe, Gabriel Bringeon, Olivier Desmettre, Pascal Pommier
Affiliations

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

Renaud Mazeron et al. Radiat Oncol. .

Abstract

Purpose: To 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 methods: Men 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.

Results: 198 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).

Conclusion: High 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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A and B. Distribution of PSA values per visit for patients who had bounce or relapsed. Figure 1A for bounce and B represents relapse.
Figure 2
Figure 2
6 week PSA value according to patients outcome: BF or bounce.
See this image and copyright information in PMC

References

    1. Ash D, Flynn A, Battermann J. et al.ESTRO/EAU/EORTC recommendations on permanent seed implantation for localized prostate cancer. Radiother Oncol. 2000;57:315–321. doi: 10.1016/S0167-8140(00)00306-6. - DOI - PubMed
    1. Nag S, Beyer D, Friedland J. et al.American Brachytherapy Society (ABS) recommendations for transperineal permanent brachytherapy of prostate cancer. Int J Radiat Oncol Biol Phys. 1999;44:789–799. doi: 10.1016/S0360-3016(99)00069-3. - DOI - PubMed
    1. Critz FA. 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 Urol. 2002;167:1310–1313. doi: 10.1016/S0022-5347(05)65288-3. - DOI - PubMed
    1. Critz FA, Levinson AK, Williams WH. et al.Prostate-specific antigen nadir: the optimum level after irradiation for prostate cancer. J Clin Oncol. 1996;14:2893–2900. - PubMed
    1. Stock RG, Klein TJ, Cesaretti JA. et al.Prognostic significance of 5-year PSA value for predicting prostate cancer recurrence after brachytherapy alone and combined with hormonal therapy and/or external beam radiotherapy. Int J Radiat Oncol Biol Phys. 2009;74:753–758. doi: 10.1016/j.ijrobp.2008.08.049. - DOI - PubMed

Substances