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PSA post nadir

Louise Dickinson, Hashim U Ahmed, Richard G Hindley, Neil McCartan, Alex Freeman, Clare Allen, Mark Emberton, Alex P Kirkham
INTRODUCTION: Focal therapy for localized prostate cancer has the potential for oncological control without the side effects of radical therapies. However, there is currently no validated method for monitoring treatment success. We assessed the diagnostic performance of prostate-specific antigen (PSA) parameters and MRI compared to histological outcomes following focal therapy. PATIENTS AND METHODS: Patients from 3 Ethics Review Board approved prospective studies of focal high intensity-focused ultrasound (HIFU) (Sonablate 500) for localized prostate cancer (T1c-T3a, Gleason grade≤4+3, and PSA≤20)...
September 20, 2016: Urologic Oncology
T T Shah, M Peters, A Kanthabalan, N McCartan, Y Fatola, J van der Voort van Zyp, M van Vulpen, A Freeman, C M Moore, M Arya, M Emberton, H U Ahmed
BACKGROUND: Treatment options for radio-recurrent prostate cancer are either androgen-deprivation therapy or salvage prostatectomy. Whole-gland high-intensity focussed ultrasound (HIFU) might have a role in this setting. METHODS: An independent HIFU registry collated consecutive cases of HIFU. Between 2005 and 2012, we identified 50 men who underwent whole-gland HIFU following histological confirmation of localised disease following prior external beam radiotherapy (2005-2012)...
September 2016: Prostate Cancer and Prostatic Diseases
Khurram M Siddiqui, Michele Billia, Andrew Arifin, Fan Li, Philippe Violette, Joseph L Chin
INTRODUCTION: and Objective: The objective of this Prospective Registry was to prospectively assess the oncologic, functional and safety outcomes of salvage HIFU in radio-recurrent prostate cancer (rrPCa). METHODS: Eighty one men were prospectively recruited and evaluated at regular scheduled study visits to 6 months post-HIFU and thereafter as per standard of care. Transrectal ultrasound guided biopsy (TRUS Bx) was performed at 6 months. Primary endpoint was absence or histologic persistence of disease at 6 months Bx...
July 12, 2016: Journal of Urology
J Cordes, J Broschk, M Sommerauer, D Jocham, A S Merseburger, C Melchert, G Kovács
BACKGROUND: We prospectively examined the effect and the safety of intensity-modulated HDR brachytherapy (IMBT) with focal dose escalation. MATERIALS AND METHODS: A total of 139 patients undergoing primary therapy for prostate cancer and 11 patients with recurrence were included. Data analysis focused on the following factors: date of primary diagnosis, Gleason score, initial prostate-specific antigen (PSA) value, PSA nadir, volume of the prostate in the transrectal ultrasound, biopsy of the prostate gland, androgen deprivation, chemotherapy, uroflowmetry, pre- and postoperative post-void residual urine (PVR), number of the needles in the prostate lobes and analysis of follow-up data...
July 4, 2016: Der Urologe. Ausg. A
Yu-Jen Wang, Chao-Yuan Huang, Wei-Hsien Hou, Chia-Chun Wang, Keng-Hsueh Lan, Hong-Jen Yu, Ming-Kuen Lai, Shihh-Ping Liu, Yeong-Shau Pu, Jason Chia-Hsien Cheng
We investigated the outcomes and the associated clinical-pathological factors in patients with prostate cancer (PCa) undergoing salvage intensity modulated radiation therapy (IMRT) for post-radical-prostatectomy (RP) biochemical failure. We report clinical outcomes of post-RP salvage IMRT, and describe chronic toxicity in these patients.Fifty patients with PCa underwent post-RP salvage IMRT. The median dose of IMRT was 70 Gy to the prostatic and seminal vesicle bed. Clinical-pathological and toxicity information were collected...
June 14, 2016: Oncotarget
Masahiko Nakayama, Hisanori Kobayashi, Tomihiro Takahara, Ryo Oyama, Keiichiro Imanaka, Kazutake Yoshizawa
BACKGROUND: Previous studies have demonstrated an association between prostate-specific antigen (PSA) kinetics and predictive value for treatment outcomes. Abiraterone acetate (AA) is a newly approved cytochrome-P450C17 inhibitor for treatment of metastatic castration-resistant prostate cancer (mCRPC), and few studies have evaluated PSA kinetics using AA so far. Results of a study evaluating PSA kinetics in the beginning of AA and enzalutamide responded chemotherapy-treated patients suggested different trends between the drugs...
2016: BMC Urology
Hideyasu Tsumura, Takefumi Satoh, Hiromichi Ishiyama, Ken-Ichi Tabata, Shouko Komori, Akane Sekiguchi, Masaomi Ikeda, Shinji Kurosaka, Tetsuo Fujita, Masashi Kitano, Kazushige Hayakawa, Masatsugu Iwamura
PURPOSE: To evaluate the prognostic value of prostate-specific antigen nadir (nPSA) after high-dose-rate (HDR) brachytherapy in clinically non-metastatic high-risk prostate cancer patients. MATERIAL AND METHODS: Data from 216 patients with high-risk or locally advanced prostate cancer who underwent HDR brachytherapy and external beam radiation therapy with long-term androgen deprivation therapy (ADT) between 2003 and 2008 were analyzed. The median prostate-specific antigen (PSA) level at diagnosis was 24 ng/ml (range: 3-338 ng/ml)...
April 2016: Journal of Contemporary Brachytherapy
Dae Keun Kim, Kyo Chul Koo, Ali Abdel Raheem, Ki Hong Kim, Byung Ha Chung, Young Deuk Choi, Koon Ho Rha
PURPOSE/OBJECTIVES: To investigate pN1 prostate cancer (PCa) patients treated surgically without immediate adjuvant treatment. MATERIALS AND METHODS: We analyzed the database of 2316 patients at our institution who underwent robot-assisted radical prostatectomy (RARP)/radical prostatectomy (RP) between July 2005 and November 2012. 87 patients with pN1 PCa and received no neoadjuvant and immediate adjuvant therapy were included in the study. Included pN1 PCa patients were followed up for median of 60 months...
2016: PloS One
Craig Wilson, David Waterhouse, Stephen E Lane, Annette Haworth, John Stanley, Tom Shannon, David Joseph
INTRODUCTION: To report long-term prostate-specific antigen (PSA) and toxicity outcomes for patients with localised prostate cancer treated with Iodine-125 permanent implantation at a single Australian centre. METHODS: Between September 1994 and November 2007, 207 patients at Sir Charles Gairdner Hospital with localised prostate cancer were consecutively treated with Iodine-125 permanent interstitial implantation. Post-therapy assessment was performed three times a month and included clinical review and biochemical (PSA) evaluation...
August 2016: Journal of Medical Imaging and Radiation Oncology
Jeong Hoon Phak, Hun Jung Kim, Woo Chul Kim
BACKGROUND: Stereotactic body radiotherapy (SBRT) has emerged as an effective treatment for localized prostate cancer. The purpose of this study was to compare the prostate-specific antigen (PSA) kinetics between conventionally fractionated external beam radiotherapy (CF-EBRT) and SBRT boost after whole pelvis EBRT (WP-EBRT) in localized prostate cancer. METHODS: A total of 77 patients with localized prostate cancer [T-stage, T1-T3; Gleason score (GS) 5-9; PSA < 20 ng/mL] were enrolled...
March 2016: Prostate International
T M Morgan, S R Hawken, K R Ghani, D C Miller, F Y Feng, S M Linsell, J A Salisz, Y Gao, J E Montie, M L Cher
BACKGROUND: We used data from the Michigan Urological Surgery Improvement Collaborative (MUSIC) to investigate the use of adjuvant and salvage radiotherapy (ART, SRT) among patients with high-risk pathology following radical prostatectomy (RP). METHODS: For patients with pT3a disease or higher and/or positive surgical margins, we examined post-RP radiotherapy administration across MUSIC practices. We excluded patients with <6 months follow-up, and those that failed to achieve a postoperative PSA nadir ⩽0...
June 2016: Prostate Cancer and Prostatic Diseases
Evan Kovac, Ahmed ElShafei, Kae Jack Tay, Melissa Mendez, Thomas J Polascik, J Stephen Jones
BACKGROUND AND OBJECTIVES: Salvage prostate cryoablation is an effective treatment for patients with localized prostate cancer relapse following primary radiotherapy. The postsalvage prostate-specific antigen (PSA) nadir that best predicts long-term biochemical progression-free survival (bPFS) is not yet defined. We sought to determine what nadir PSA best predicted success following salvage whole-gland cryoablation. PATIENTS AND METHODS: We retrospectively reviewed a cohort of 486 hormone-naive patients who underwent salvage whole-gland cryoablation from the Cryo On-Line Database (COLD)...
June 2016: Journal of Endourology
Charles Van Praet, Sylvie Rottey, Fransien Van Hende, Gino Pelgrims, Wim Demey, Filip Van Aelst, Wim Wynendaele, Thierry Gil, Peter Schatteman, Bertrand Filleul, Dennis Schallier, Jean-Pascal Machiels, Dirk Schrijvers, Els Everaert, Lionel D'Hondt, Patrick Werbrouck, Joanna Vermeij, Jeroen Mebis, Marylene Clausse, Marika Rasschaert, Joanna Van Erps, Jolanda Verheezen, Jan Van Haverbeke, Jean-Charles Goeminne, Nicolaas Lumen
BACKGROUND: Abiraterone acetate (AA) is licensed for treating metastatic castration-resistant prostate cancer (mCRPC). Real-world data on oncological outcome after AA are scarce. The current study assesses efficacy and safety of AA in mCRPC patients previously treated with docetaxel who started treatment during the Belgian compassionate use program (January 2011-July 2012). PATIENTS AND METHODS: Records from 368 patients with mCRPC from 23 different Belgian hospitals who started AA 1000mg per day with 10mg prednisone or equivalent were retrospectively reviewed (September 2013-December 2014)...
June 2016: Urologic Oncology
Mekhail Anwar, Vivian Weinberg, Zachary Seymour, I Joe Hsu, Mack Roach, Alex R Gottschalk
BACKGROUND AND PURPOSE: Treatment of intermediate and high-risk prostate cancer with a high BED has been shown to increase recurrence free survival (RFS). While high dose rate (HDR) brachytherapy, given as a boost is effective in delivering a high BED, many patients are not candidates for the procedure or wish to avoid an invasive procedure. We evaluated the use of stereotactic body radiotherapy (SBRT) as a boost, with dosimetry modeled after HDR-boost. MATERIAL AND METHODS: Fifty patients were treated with two fractions of SBRT (9...
2016: Radiation Oncology
Detlef Bartkowiak, Dirk Bottke, Reinhard Thamm, Alessandra Siegmann, Wolfgang Hinkelbein, Thomas Wiegel
BACKGROUND AND PURPOSE: In a retrospective analysis, we examined factors influencing the outcome of prostate cancer (PCa) patients receiving salvage radiotherapy (SRT) for PSA recurrence after radical prostatectomy (RP). MATERIAL AND METHODS: 306 patients received 3D-conformal SRT at a median pre-SRT PSA of 0.298 ng/ml. Post-SRT progression was defined as PSA ⩾0.2 ng/ml above nadir and rising further, or hormone treatment, or clinical recurrence. Data were analyzed with the Kaplan-Meier method and multivariable Cox regression...
January 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Aryavarta M S Kumar, Kristin L Smith, Chandana A Reddy, Kevin L Stephans, Eric A Klein, Jay P Ciezki
PURPOSE: To report efficacy in our series of nodular recurrences in the post-surgical bed that underwent salvage low-dose-rate (LDR) brachytherapy. MATERIAL AND METHODS: Patients with radical prostatectomy (RP) who had biochemical failure with nodular recurrence detected by DRE, ultrasound, and pelvic CT and then salvaged with LDR (125)I brachytherapy were included. Nodular recurrences were biopsy confirmed adenocarcinoma, and patients had no evidence of nodal or distant metastasis on imaging including bone scan...
August 2015: Journal of Contemporary Brachytherapy
R van Velthoven, F Aoun, Q Marcelis, S Albisinni, M Zanaty, M Lemort, A Peltier, K Limani
BACKGROUND: Focal therapy is an emerging mini-invasive treatment modality for localized prostate cancer aimed to reduce the morbidity associated with radical therapy while maintaining optimal cancer control. We report the mid-term oncological and functional results of primary hemiablation high-intensity focused ultrasound (HIFU) in a prospective cohort of patients. METHODS: Over 8 years, hemiablation HIFU was primarily performed in 50 selected patients with biopsy-proven clinically localized unilateral, low-intermediate risk prostate cancer in complete concordance with the prostate cancer lesions identified by magnetic resonance imaging with precise loci matching on multimodal approach...
March 2016: Prostate Cancer and Prostatic Diseases
Magali Quivrin, Romaric Loffroy, Luc Cormier, Frédéric Mazoyer, Aurélie Bertaut, Damien Chambade, Etienne Martin, Philippe Maingon, Paul Walker, Gilles Créhange
PURPOSE: To determine whether post-implant MRI-based dosimetry of the Dominant Intra-prostatic Lesion (DIL) could best predict the occurrence of PSA bounce after prostate brachytherapy. METHODS AND MATERIALS: We selected 66 patients with a low risk prostate cancer treated with (125)I prostate brachytherapy as monotherapy. Post-implant dosimetry based on day 30 CT-scan and multiparametric MRI co-registration was generated: planned D90, D95, V100, V150 values were calculated for each DIL...
November 2015: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
J A Gordon, A Midha, A Szeitz, M Ghaffari, H H Adomat, Y Guo, T L Klassen, E S Guns, K M Wasan, M E Cox
BACKGROUND: Growing evidence supports the idea that de novo steroidogenesis has an important role in prostate cancer's progression to the castration-resistant state following androgen deprivation therapy. Therefore, reducing the availability of cholesterol for use as a precursor in androgen synthesis may reduce proliferation and disease progression. METHODS: LNCaP xenograft-bearing mice were castrated and administered simvastatin via diet, and tumor volume and PSA concentration were monitored for 8 weeks post castration...
March 2016: Prostate Cancer and Prostatic Diseases
Jose López-Torrecilla, Anna Boladeras, María Angeles Cabeza, Almudena Zapatero, Josep Jove, Luis M Esteban, Ivan Henriquez, Manuel Casaña, Carmen González-San Segundo, Antonio Gómez-Caamaño, Jose Luis Mengual, Asunción Hervás, Julia Luisa Muñoz, Gerardo Sanz
BACKGROUND: Nomograms were established to predict biochemical recurrence (BCR) after radiotherapy (RT) with a low weight of the characteristic variables of RT and androgen deprivation therapy (ADT). Our aim is to provide a new stratified tool for predicting BCR at 4 and 7 years in patients treated using RT with radical intent. MATERIALS AND METHODS: A retrospective, nonrandomized analysis was performed on 5044 prostate cancer (PCa) patients with median age 70 years, who received RT-with or without ADT-between November 1992 and May 2007...
October 2015: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
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