PSA level three months after radiation tx may predict outcome
Alex K. Bryant, from University of California at San Diego, and colleagues used Veterans Affairs data to identify 5,783 patients with intermediate-risk or high-risk localized prostate cancer who were diagnosed between 2000 and 2015 and treated with RT and androgen deprivation therapy. Patients were characterized by three-month post-RT PSA values: <0.10 ng/mL, 0.10 to 0.49 ng/mL, and ≥0.50 ng/mL.
The researchers found that a higher three-month PSA level was strongly associated with biochemical progression-free survival (bPFS), prostate cancer-specific survival (PCSS), and overall survival (OS). Greater hazards were noted for patients with a three-month PSA level ≥0.50 ng/mL versus a three-month PSA value <0.10 ng/mL (hazard ratios: bPFS, 5.23; PCSS, 3.97; and OS, 1.50 [P < 0.001 for all]). Greater hazards were also seen for patients with a three-month PSA value of 0.10 to 0.49 ng/mL (hazard ratios: bPFS, 2.41 [P < 0.001]; PCSS, 2.29 [P < 0.001]; and OS, 1.21 [P = 0.003]). When analyzed separately, three-month PSA levels were found to be predictive of OS in the high-risk group (P < 0.001) but not the intermediate-risk group (P = 0.21).
"The three-month PSA measurement may augment clinical decision making and holds promise as a potential surrogate end point in clinical trials," the authors write.
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