Benitez Nicolas Feltes, Lozano Joan, Forero Carlos G, I Truyols Montserrat Colomer, Rubio Saturio Paredes, Jovell-Fernandez Esther
Radiation Oncology Department, University Center, Consorci Sanitari de Terrassa, Ctra. De Torrebonica, s/n, 08227, Terrassa, Spain.
Department of Medicine, School of Medicine and Haalth Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, 08195, Sant Cugat del Vallès, Spain.
Clin Transl Oncol. 2024 Dec 20. doi: 10.1007/s12094-024-03816-7.
Prostate-specific antigen (PSA) bounce is a transient elevation in PSA levels commonly observed after radiotherapy. This study aims to investigate the characteristics, timing, and clinical implications of PSA bounce (PSA-B) in prostate cancer patients treated with external beam radiotherapy (EBRT), exploring potential causes and its relevance in patient management.
Between 2013 and 2019, 629 patients with localized prostate cancer were treated with EBRT. After excluding patients with fewer than four PSA measurements or follow-up under 3 years (n = 184), 445 patients were analyzed. The median follow-up duration was 5.9 years (36-105 months). PSA-B was defined as a rise of ≥ 0.2 ng/mL above the nadir, followed by a subsequent decline to or below the nadir. PSA relapse was defined according to Phoenix definition.
A total of 64 patients (14.4%) experienced PSA-B at a median of 31 months (6-68 months). Univariable analysis identified age (p < 0.001), risk group (p < 0.001), perineural invasion (p < 0.007), radiotherapy duration (p < 0.001), and the absence of concurrent hormonal therapy (p < 0.001) as independent predictors of PSA-B. Multivariable analysis confirmed age and high-risk group as significant factors. PSA relapse occurred in 10.3% of cases, with only one patient who experienced both PSA-B and relapse.
PSA-B is a common phenomenon in localized prostate cancer patients post-EBRT. Factors such as age, risk group, perineural invasion, radiotherapy duration, and hormonal treatment use are associated with PSA-B occurrence. Understanding its mechanisms is crucial for optimizing prostate cancer management.
前列腺特异性抗原（PSA）反弹是放疗后常见的PSA水平短暂升高。本研究旨在调查接受外照射放疗（EBRT）的前列腺癌患者中PSA反弹（PSA-B）的特征、时间及临床意义，探讨其潜在原因及其在患者管理中的相关性。
2013年至2019年间，629例局限性前列腺癌患者接受了EBRT治疗。排除PSA测量次数少于4次或随访时间不足3年的患者（n = 184）后，对445例患者进行分析。中位随访时间为5.9年（36 - 105个月）。PSA-B定义为比最低点升高≥0.2 ng/mL，随后降至或低于最低点。PSA复发根据Phoenix定义确定。
共有64例患者（14.4%）经历了PSA-B，中位时间为31个月（6 - 68个月）。单因素分析确定年龄（p < 0.001）、风险组（p < 0.001）、神经周围侵犯（p < 0.007）、放疗持续时间（p < 0.001）以及未进行同步激素治疗（p < 0.001）为PSA-B的独立预测因素。多因素分析证实年龄和高危组是显著因素。10.3%的病例发生了PSA复发，只有1例患者同时经历了PSA-B和复发。
PSA-B是局限性前列腺癌患者EBRT治疗后的常见现象。年龄风险组、神经周围侵犯、放疗持续时间和激素治疗的使用等因素与PSA-B的发生有关。了解其机制对于优化前列腺癌管理至关重要。
