PSA BOUNCE AFTER BRACHYTHERAPY WITH PERMANENT SEED IMPLANTATION FOR PROSTATE CANCER

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  • Yagi Yasuto
    The Department of Urology, National Hospital Organization Tokyo Medical Center
  • Namitome Ryo
    The Department of Urology, National Hospital Organization Tokyo Medical Center
  • Kono Yuho
    The Department of Urology, National Hospital Organization Tokyo Medical Center
  • Nishiyama Toru
    The Department of Urology, National Hospital Organization Tokyo Medical Center
  • Toya Kazuhito
    The Department of Radiation Oncology, National Hospital Organization Tokyo Medical Center
  • Yorozu Atsunori
    The Department of Radiation Oncology, National Hospital Organization Tokyo Medical Center
  • Saito Shiro
    The Department of Urology, National Hospital Organization Tokyo Medical Center

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Other Title
  • 前立腺癌永久挿入密封小線源療法後におけるPSA bounceの検討
  • ゼンリツセンガン エイキュウ ソウニュウ ミップウ ショウセン ゲン リョウホウ ゴ ニ オケル PSA bounce ノ ケントウ

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Abstract

(Purpose) To evaluate prostate specific antigen (PSA) bounce that may occur as a time PSA rise phenomenon during follow up period after brachytherapy (BT) with permanent seed implantation for prostate cancer.<br> (Materials and methods) Seven hundred and forty-six patients had undergone BT from November 2003 to April 2007 in a single institute, and of 130 patients who did not receive hormone therapy and had minimal 3-year follow up are analyzed. PSA bounce was defined as a rise of at least 0.4ng/ml with spontaneous return to pre-bounce level or lower.<br> (Result) Among the 130 patients, 40 patients (30.8%) developed PSA bounce, and median time to PSA bounce was 18 months after the BT. With univariate analysis, younger patients (P=0.027) and larger prostate (P=0.030) had statistically significant correlation with PSA bounce. With multivariate analysis, younger patients were identified as only independent factor for predicting PSA bounce.<br> Eight patients out of 130 patients (6.2%) triggered the Phoenix definition (nadir+2ng/ml) of PSA failure, however, clinical failure was seen only in 3 patients, and other 5 patients were considered as PSA bounce.<br> (Conclusion) PSA bounce is likely to occur in younger patients within 3 years after BT. It is clinically important to distinguish PSA bounce from PSA failure during following period after BT.<br>

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