Selection of patients who would not require long-term prostate-specific antigen monitoring after low-dose-rate brachytherapy

Naoya Niwa, Kazuhiro Matsumoto, Toru Nishiyama, Yasuto Yagi, Choichiro Ozu, Ken Nakamura, Shiro Saito, Mototsugu Oya

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Purpose: To identify patients at extremely low risk of biochemical recurrence (BCR) of prostate cancer after low-dose-rate brachytherapy (LDR-BT) to determine when prostate-specific antigen (PSA) monitoring can be stopped. Methods and Materials: We retrospectively reviewed clinicopathologic data of patients with prostate cancer who underwent LDR-BT between 2003 and 2011. Of 1569 patients reviewed, 689 (43.9%) received combination external beam radiotherapy, and 970 (61.8%) had neoadjuvant hormonal therapy. We stratified patients according to risk factors identified by multivariate analysis and assessed the factors for an association with BCR (defined as ≥2 ng/mL higher than the nadir). Results: The median followup was 96 months. Of 1531 patients who were BCR-free at 3 years after treatment, 76 subsequently developed BCR; of 1500 who were BCR-free at 5 years, 45 eventually had BCR. On multivariate analysis, independent risk factors for BCR were the National Comprehensive Cancer Network risk group at diagnosis and PSA levels at 3 or 5 years after radiotherapy. In the low-risk group, no patient with a PSA level ≤0.2 ng/mL at 3 years after radiotherapy subsequently developed BCR. In the intermediate-risk group, no patients with a PSA level ≤0.2 ng/mL at 5 years subsequently developed BCR. Conclusions: The National Comprehensive Cancer Network risk group at diagnosis and PSA values at 3 and 5 years after LDR-BT are independently associated with a risk of later BCR. Using these two factors may help to select patients for whom PSA monitoring could be stopped because they have an extremely low risk of later BCR.

Original languageEnglish
Pages (from-to)899-905
Number of pages7
JournalBrachytherapy
Volume17
Issue number6
DOIs
Publication statusPublished - 2018 Nov 1

Keywords

  • Brachytherapy
  • Followup
  • Prostate-specific antigen
  • Prostatic cancer
  • Recurrence
  • Surveillance

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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