Minimal percentage of dose received by 90% of the urethra %UD90 is the most significant predictor of PSA bounce in patients who underwent low-dose-rate brachytherapy LDR-brachytherapy for prostate cancerReportar como inadecuado




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BMC Urology

, 12:28

Urological oncology

Abstract

BackgroundTo clarify the significant clinicopathological and postdosimetric parameters to predict PSA bounce in patients who underwent low-dose-rate brachytherapy LDR-brachytherapy for prostate cancer.

MethodsWe studied 200 consecutive patients who received LDR-brachytherapy between July 2004 and November 2008. Of them, 137 patients did not receive neoadjuvant or adjuvant androgen deprivation therapy. One hundred and forty-two patients were treated with LDR-brachytherapy alone, and 58 were treated with LDR-brachytherapy in combination with external beam radiation therapy. The cut-off value of PSA bounce was 0.1 ng-mL. The incidence, time, height, and duration of PSA bounce were investigated. Clinicopathological and postdosimetric parameters were evaluated to elucidate independent factors to predict PSA bounce in hormone-naïve patients who underwent LDR-brachytherapy alone.

ResultsFifty patients 25% showed PSA bounce and 10 patients 5% showed PSA failure. The median time, height, and duration of PSA bounce were 17 months, 0.29 ng-mL, and 7.0 months, respectively. In 103 hormone-naïve patients treated with LDR-brachytherapy alone, and univariate Cox proportional regression hazard model indicated that age and minimal percentage of the dose received by 30% and 90% of the urethra were independent predictors of PSA bounce. With a multivariate Cox proportional regression hazard model, minimal percentage of the dose received by 90% of the urethra was the most significant parameter of PSA bounce.

ConclusionsMinimal percentage of the dose received by 90% of the urethra was the most significant predictor of PSA bounce in hormone-naïve patients treated with LDR-brachytherapy alone.

KeywordsProstate cancer Brachytherapy PSA bounce Post-dosimetry UD90 % Electronic supplementary materialThe online version of this article doi:10.1186-1471-2490-12-28 contains supplementary material, which is available to authorized users.

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Autor: Nobumichi Tanaka - Isao Asakawa - Kiyohide Fujimoto - Satoshi Anai - Akihide Hirayama - Masatoshi Hasegawa - Noboru Konishi

Fuente: https://link.springer.com/







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