Prostate-specific antigen kinetics and biochemical control following stereotactic body radiation therapy, high dose rate brachytherapy, and low dose rate brachytherapy: A multi-institutional analysis of 3502 patients

•The kinetics of PSA decline differed between SBRT, HDR-BT, and LDR-BT.•Lower nPSA, longer decay to nPSA, and greater achievement of PSA 4 years post-treatment was predictive of durable biochemical control. Stereotactic body radiation therapy (SBRT), low dose rate brachytherapy (LDR-BT) and high dos...

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Published in:Radiotherapy and oncology 2020-10, Vol.151, p.26-32
Main Authors: Levin-Epstein, Rebecca, Cook, Ryan R., Wong, J. Karen, Stock, Richard G., Jeffrey Demanes, D., Collins, Sean P., Aghdam, Nima, Suy, Simeng, Mantz, Constantine, Katz, Alan J., Nickols, Nicholas G., Miszczyk, Leszek, Napieralska, Aleksandra, Namysl-Kaletka, Agnieszka, Prionas, Nicholas D., Bagshaw, Hilary, Buyyounouski, Mark K., Cao, Minsong, Mahal, Brandon A., Shabsovich, David, Dang, Audrey, Yuan, Ye, Rettig, Matthew B., Chang, Albert J., Jackson, William C., Spratt, Daniel E., Lehrer, Eric J., Zaorsky, Nicholas G., Kupelian, Patrick A., Steinberg, Michael L., Horwitz, Eric M., Jiang, Naomi Y., Kishan, Amar U.
Format: Article
Language:English
Subjects:
Androgen Antagonists
Brachytherapy
Humans
Kinetics
Male
Prostate cancer
Prostate-specific antigen
Prostate-Specific Antigen - metabolism
Prostatic Neoplasms - radiotherapy
Prostatic Neoplasms - surgery
Radiosurgery
Radiotherapy Dosage
Retrospective Studies
SBRT
Stereotactic body radiation therapy
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Summary:•The kinetics of PSA decline differed between SBRT, HDR-BT, and LDR-BT.•Lower nPSA, longer decay to nPSA, and greater achievement of PSA 4 years post-treatment was predictive of durable biochemical control. Stereotactic body radiation therapy (SBRT), low dose rate brachytherapy (LDR-BT) and high dose rate brachytherapy (HDR-BT) are ablative-intent radiotherapy options for prostate cancer (PCa). These vary considerably in dose delivery, which may impact post-treatment prostate-specific antigen (PSA) patterns and biochemical control. We compared PSA kinetics between SBRT, HDR-BT, and LDR-BT, and assessed their relationships to biochemical recurrence-free survival (BCRFS). Retrospective PSA data were analyzed for 3502 men with low-risk (n = 2223; 63.5%), favorable intermediate-risk (n = 869; 24.8%), and unfavorable intermediate-risk (n = 410; 11.7%) PCa treated with SBRT (n = 1716; 49.0%), HDR-BT (n = 512; 14.6%), or LDR-BT (n = 1274; 36.4%) without upfront androgen deprivation therapy at 10 institutions from 1990 to 2017. We compared nadir PSA (nPSA), time to nPSA, achievement of nPSA
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2020.07.014