Martell Kevin, Meyer Tyler, Sia Michael, Angyalfi Steve, Husain Siraj
Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta.
Department of Oncology, University of Calgary, Calgary, Alberta.
J Contemp Brachytherapy. 2017 Apr;9(2):99-105. doi: 10.5114/jcb.2017.67198. Epub 2017 Apr 13.
To develop a model for prostate specific antigen (PSA) values at one year among patients treated with intraoperatively planned I prostate brachytherapy (IOPB).
Four hundred and deven patients treated with IOPB for prostate adenocarcinoma were divided into four groups: those with PSA values ≥ 3 ng/ml; < 3 and ≥ 2; < 2 and ≥ 1 or PSA < 1 between 10.5 and 14.5 months post implantation (1yPSA). Ordinal regression analysis was then performed between patient, tumor, and treatment characteristics. 1yPSA values were also compared with toxicity outcomes.
Median 1yPSA was 0.77 (0.04-17.36). Thirty-two patients (8%) had a PSA ≥ 3; 35 (9%) had PSA < 3, ≥ 2; 87 (21%) had PSA < 2, ≥ 1, and most patients 254 (62%) had PSA < 1. PSA response was independent of gland volume, Gleason score, clinical stage, seed activity, V, V, D, or number of needles and seeds used. Older patients had significantly lower 1yPSA; median ages 65.1 (46.5-81.0), 62.1 (50.4-79.5), 60.5 (47.1-80.3), and 58.1 (45.1-74.2) years for each of the 1yPSA groups respectively ( < 0.001). Also, both implant V ( < 0.001) and initial PSA values ( = 0.04) were predictive of 1yPSA values. There was no correlation between 1yPSA values and toxicity encountered.
PSA response at 1 year post IOPB appears to be dependent on patient age, initial PSA, and implant V. Our results provide reassurance that parameters other than biochemical failure influence 1yPSA values.
建立术中计划的I期前列腺近距离放射治疗（IOPB）患者一年时前列腺特异性抗原（PSA）值的模型。
411例接受IOPB治疗前列腺腺癌的患者被分为四组：植入后10.5至14.5个月时PSA值≥3 ng/ml；<3且≥2；<2且≥1或PSA<1（1年PSA）。然后对患者、肿瘤和治疗特征进行有序回归分析。还比较了1年PSA值与毒性结果。
1年PSA中位数为0.77（0.04 - 17.36）。32例患者（8%）PSA≥3；35例（9%）PSA<3且≥2；87例（21%）PSA<2且≥1，大多数患者254例（62%）PSA<1。PSA反应与腺体体积、Gleason评分、临床分期、种子活性、V、V、D或所用针数和种子数无关。老年患者的1年PSA显著较低；1年PSA各分组的中位年龄分别为65.1（46.5 - 81.0）、62.1（50.4 - 79.5）、60.5（47.1 - 80.3）和58.1（45.1 - 74.2）岁（P<0.001）。此外，植入V（P<0.001）和初始PSA值（P = 0.04）均为1年PSA值的预测因素。1年PSA值与所遇毒性之间无相关性。
IOPB术后1年的PSA反应似乎取决于患者年龄、初始PSA和植入V。我们的结果表明，除生化失败外的其他参数会影响1年PSA值，这一点令人安心。
