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With radiation alone, pretreatment PSA velocity predicts

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Int J Radiat Oncol Biol Phys. 2007 Apr 1;67(5):1425-9.

Pretreatment PSA velocity as a predictor of disease outcome following radical radiation therapy.

Palma D, Tyldesley S, Blood P, Liu M, Morris J, Pickles T; Prostate Cohort Outcomes Initiative.

Radiation Oncology Program, British Columbia Cancer Agency, Vancouver, British Columbia, Canada. dpalma@bccancer.bc.ca


PURPOSE: Pretreatment prostate-specific antigen velocity (PSAV) greater than 2.0 ng/mL/year has been identified as a predictor of disease-specific survival (DSS) and overall survival (OS) after radiotherapy for prostate adenocarcinoma. This study aimed to independently verify if pretreatment PSAV is associated with biochemical disease-free survival (bDFS), DSS, or OS in men undergoing radiation therapy.

METHODS AND MATERIALS: A total of 473 patients treated with radiation therapy for localized prostate cancer formed the study cohort. No men received neoadjuvant or adjuvant hormones. Kaplan-Meier and Cox regression analysis were used to evaluate if PSAV predicted disease endpoints.

RESULTS: Men with a PSAV greater than 2.0 ng/mL/year had a shorter bDFS compared with men with a PSAV of 2.0 ng/mL/year or less (median, bDFS 68 months vs. 97 months; p = 0.0003). However, on multivariate analysis, PSAV was no longer a significant predictor of bDFS in the entire cohort (p = 0.09). PSAV did not predict DSS or OS (p = 0.55 and p = 0.99, respectively). In patients with high-risk disease, PSAV predicted bDFS on univariate (p = 0.0002) and multivariate (p = 0.02) analysis, but not DSS or OS.

CONCLUSION: Pretreatment PSAV greater than 2.0 ng/mL/year is associated with reduced bDFS. However, PSAV is an independent predictor of bDFS only in high-risk patients. PSAV does not predict survival outcomes.

PMID: 17394943 Forum: Other prostate cancer topics including radiation Title: With radiation alone, pretreatment PSA velocity predicts biological progression not survival

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