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Early PSA decrease is an independent predictive factor of clinical failure and specific survival in patients with localized prostate cancer treated by radiotherapy with or without androgen deprivation therapy
Annals of Oncology, 10/16/09

de Crevoisier R et al. – A PSA decline 6 weeks after the start of EBRT when used as monotherapy and 3 months after the start of ADT in patients treated with combined ADT and EBRT is predictive of progression and specific survival.

Methods

448 patients with prostate cancer received EBRT alone (n = 361, group 1) or ADT followed by EBRT (n = 87, group 2)
In group 2, ADT initiated 3 months before EBRT
After baseline PSA determination (PSApreRT), PSA was assessed during the 6th week of the EBRT course (PSA6wRT) in group 1
In group 2, PSA measured again 3 months after start of ADT, before EBRT (PSAADT-preRT)

Results

In group 1, median PSA6wRT/PSApreRT 0.72 and median prostate-specific antigen velocity (PSAV) was –1.5 ng/ml/month.
In multivariate analysis, prognostic groups and PSA6wRT/PSApreRT (or PSAV) independently predicted biochemical failure (BF), clinical failure (CF), and prostate cancer-specific survival
In group 2, the median PSAADT-preRT was 1.3 ng/ml
In high-risk group, an undetectable PSAADT-preRT (0.2 ng/ml) predicted BF and CF

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