Short-term androgen deprivation and PSA doubling time: their association and relationship to disease progression after radiation therapy for prostate cancer

2004 ◽  
Vol 58 (1) ◽  
pp. 43-52 ◽  
Author(s):  
Alexandra L Hanlon ◽  
Eric M Horwitz ◽  
Gerald E Hanks ◽  
Alan Pollack
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Disease Progression ◽  
Doubling Time ◽  
Androgen Deprivation ◽  
Short Term ◽  
Psa Doubling Time

Impact of comorbidity and PSA doubling time on the risk of death in men experiencing PSA failure following radiation therapy with or without androgen deprivation therapy for unfavorable-risk prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 68-68
Author(s):  
Sagar Anil Patel ◽  
Ming-Hui Chen ◽  
Marian Loffredo ◽  
Andrew A. Renshaw ◽  
Philip W. Kantoff ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Androgen Deprivation Therapy ◽  
Doubling Time ◽  
Androgen Deprivation ◽  
Psa Doubling Time ◽  
Psa Failure ◽  
Severe Comorbidity ◽  
The Impact

68 Background: The optimal management of men with PSA failure following initial prostate cancer therapy based on comorbidity is unknown. We investigated the impact that PSA doubling time (DT) and comorbidity had on the risk of all cause (AC), prostate cancer-specific (PCS) and other cause mortality (OCM) following PSA failure. Methods: Between 1995 and 2001, 206 men with unfavorable-risk PC were randomized to receive radiation therapy alone or in combination with 6 months of androgen deprivation therapy (ADT). After a median follow up of 16.2 years, 108 men experienced PSA failure (85, no or minimal; 23, moderate to severe comorbidity) and formed the study cohort. Cox and Fine-Gray regression analysis was used to determine whether PSA DT was associated with the risk of ACM and PCSM/OCM respectively, stratified by ACE-27 comorbidity score. Results: After a median follow up of 13.71 years following PSA failure, 81 of the 108 men (75%) died. Longer PSA DT was associated with a decreased risk of PCSM in men with no/minimal (AHR 0.33, 95% CI 0.17-0.65, p= 0.001) and moderate/severe comorbidity (AHR 0.014, 95% CI 0.002-0.129, p= 0.0002) with a trend toward an increased risk of OCM in men with no/minimal (AHR 1.42, 95% CI 0.94-2.16, p= 0.10) and moderate/severe comorbidity (AHR 1.68, 95% CI 0.85-3.35, p= 0.14). However, increasing PSA DT was only associated with a decreased risk of ACM in men with no/minimal (AHR 0.69, 95% CI 0.50-0.96, p = 0.03) but not moderate/severe comorbidity (AHR 0.95, 95% CI 0.51-1.78, p= 0.87). Conclusions: The extent and natural history of comorbidity as well as PSA DT should be taken into consideration when deciding on appropriate management and/or clinical trial eligibility at the time of PSA failure. Specifically, randomized studies are needed to determine whether survival is prolonged in men with life-shortening comorbidity with salvage ADT at the time of PSA failure versus surveillance and reserving ADT use for symptomatic progression. For all other men, trials comparing ADT with or without novel agents shown to prolong survival in men with metastatic castrate resistant PC is warranted.

scholarly journals The change of PSA doubling time and its association with disease progression in patients with biochemically relapsed prostate cancer treated with intermittent androgen Deprivation

The Prostate ◽  
2011 ◽  
Vol 71 (15) ◽  
pp. 1608-1615 ◽  
Author(s):  
Daniel Keizman ◽  
Peng Huang ◽  
Emmanuel S. Antonarakis ◽  
Victoria Sinibaldi ◽  
Michael A. Carducci ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Progression ◽  
Doubling Time ◽  
Androgen Deprivation ◽  
Psa Doubling Time

Determining if pretreatment PSA doubling time predicts PSA trajectories after radiation therapy for localized prostate cancer

2009 ◽  
Vol 90 (3) ◽  
pp. 389-394 ◽  
Author(s):  
Daniel E. Soto ◽  
Rebecca R. Andridge ◽  
Charlie C. Pan ◽  
Scott G. Williams ◽  
Jeremy M.G. Taylor ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Doubling Time ◽  
Localized Prostate Cancer ◽  
Psa Doubling Time

Effect of adding short-term androgen deprivation therapy to dose-escalated radiation therapy on failure-free survival for select men with intermediate-risk prostate cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 176-176
Author(s):  
Shelly Bian ◽  
Deborah A. Kuban ◽  
Lawrence B. Levy ◽  
Jeong Hoon Oh ◽  
Katherine Castle ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Androgen Deprivation Therapy ◽  
Recursive Partitioning ◽  
Androgen Deprivation ◽  
Intermediate Risk ◽  
Short Term ◽  
Free Survival ◽  
Risk Prostate Cancer ◽  
Severe Comorbidity

176 Background: Independently, dose-escalated external beam radiation therapy (DE-EBRT) and short-term androgen deprivation therapy (ADT) improve outcomes for men with intermediate-risk prostate cancer; however, the incremental benefit of adding short-term ADT to DE-EBRT is uncertain. The aim of this study was to determine the effect of adding ADT to DE-EBRT and to identify men most likely to benefit from ADT. Methods: We reviewed the medical records of 636 men treated for intermediate-risk prostate cancer with DE-EBRT (>75 Gy) from 1995 to 2009. The adult comorbidity evaluation-27 index categorized severity of comorbidity. Recursive partitioning analysis defined unfavorable disease. Kaplan-Meier and log-rank tests compared failure-free survival (FFS) with and without ADT. Results: Median age was 70 years (interquartile range [IQR] 65–74). Overall, 45% received DE-EBRT alone and 55% DE-EBRT with ADT (median 6 months, IQR 6-8). Median follow up was 4.3 years. On Cox-proportional hazard regression analysis that adjusted for differences in comorbidities and tumor characteristics, administration of ADT improved FFS (adjusted hazard ratio 0.36, 95% confidence interval 0.18–0.72; p=0.004). Recursive partitioning analysis of men without ADT classified Gleason 4+3=7 or ≥ 50% positive cores as unfavorable disease (5-year FFS 96.3% favorable vs. 81.6% unfavorable; p<0.001). The addition of ADT to DE-EBRT improved 5-year FFS for men with unfavorable disease (n=334; 81.6% vs. 92.9%; p=0.009) but did not improve FFS for men with favorable disease (n=302; 96.3% vs. 97.4%; p=0.874). When stratified by comorbidity, ADT improved FFS for men with unfavorable disease and no or mild comorbidity (p=0.006) but did not improve FFS for men with unfavorable disease and moderate to severe comorbidity (p=0.380). Conclusions: The addition of ADT to DE-EBRT improves FFS for men with unfavorable intermediate-risk prostate cancer (Gleason 4+3=7 or ≥ 50% positive cores) especially those with no or minimal comorbidity. Men with favorable intermediate-risk disease or with moderate to severe comorbidity may not benefit from the addition of ADT to DE-EBRT.

PSA levels, PSA doubling time, Gleason score and prior therapy cannot predict measured uptake of [68Ga]PSMA-HBED-CC lesion uptake in recurrent/metastatic prostate cancer

2017 ◽  
Vol 56 (06) ◽  
pp. 225-232 ◽  
Author(s):  
David Pfister ◽  
Natascha Drude ◽  
Felix Mottaghy ◽  
Florian Behrendt ◽  
Frederik Verburg
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Androgen Deprivation Therapy ◽  
Gleason Score ◽  
Doubling Time ◽  
Lesion Size ◽  
Tracer Uptake ◽  
Androgen Deprivation ◽  
Pet Ct

SummaryAim: To assess whether clinical prostate cancer (PCA) related factors and therapy status can predict the degree of tracer uptake on [68Ga]PSMA-HBED-CC PET/CT.Materials & methods: We retrospectively studied 124 patients with recurrent an/or metastatic PCA who underwent [68Ga]PSMAHBED-CC PET/CT. The maximum standardized uptake value (SUVmax) was determined in the prostate bed as well as in three size categories (≤ 5 mm, > 5–15 mm, > 15 mm) in pelvic lymph node, extrapelvic lymph node, bone and visceral metastases.Results: Significant positive correlations between lesion size and SUVmax were found in pelvic lymph node metastases > 5 -≤15 mm (Spearmans rho = 0.502, p = 0.002) as well as in extrapelvic lymph node metastases5 mm (rho = 0.314, p = 0.033) and > 5 ≤-15 mm (rho = 0.614, p < 0.001). SUVmax tended to be higher in the largest diameter category in each anatomic station than in the middle and lower categories. We were unable to find evidence for a relationship between SUVmax and PSA, PSAdt, Gleason score, androgen deprivation therapy, radiation therapy or chemotherapy status.Conclusion: Measured tracer uptake in [68Ga]PSMA-HBED-CC PET/CT in patients with recurrent/metastasized prostate cancer is significantly influenced by lesion size as a result of partial volume effects in the very small lesions. Clinical indicators of aggressive prostate cancer behaviour such as PSA levels, PSA doubling time or the Gleason score of the primary tumour, as well as the androgen deprivation therapy, radiation therapy or chemotherapy status are not related to measured tracer uptake.

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