Hanks G E, Hanlon A L, Lee W R, Slivjak A, Schultheiss T E
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelpha, PA 19111, USA.
Int J Radiat Oncol Biol Phys. 1996 Feb 1;34(3):549-53. doi: 10.1016/0360-3016(95)02154-x.
The distribution of pretreatment and posttreatment prostate specific antigen (PSA) doubling times (PSADT) varies widely. This report examines the pretreatment PSADT as an independent predictor of biochemical freedom from disease (bNED) and describes the clinical utility of PSADT.
Ninety-nine patients with T1-3 NX, M-0 prostate cancer treated between February 1989 and November 1993 have pretreatment PSADTs calculated from three or more PSA levels. Biochemical disease-free (bNED) survival (failure is PSA > or = 1.5 ngm/ml and rising) is evaluated by multivariate analysis of common prognostic indicators and PSADT.
Prostate-specific antigen doubling time (PSADT) is a significant predictor of survival along with radiation dose. Patients with a pretreatment PSADT of < 12 months show 50% failure by 18 months, while those with a PSADT that is not increasing show only 3% failure at 3 years.
Prostate-specific antigen doubling time (PSADT) is a predictor of bNED outcome in prostate cancer. Patients with PSADT < 12 months have aggressive disease, and should be considered for multimodal therapy. Slow PSADT (> or = 5 years) is observed in 57% of patients, and this end point may be considered in the decision to observe rather than to treat. After treatment failure, the PSADT may be used to determine which patients do not need immediate androgen deprivation.
治疗前和治疗后前列腺特异性抗原（PSA）倍增时间（PSADT）的分布差异很大。本报告研究治疗前PSADT作为无生化疾病（bNED）的独立预测指标，并描述PSADT的临床应用价值。
1989年2月至1993年11月期间接受治疗的99例T1-3 NX、M-0前列腺癌患者，根据三个或更多PSA水平计算治疗前PSADT。通过对常见预后指标和PSADT进行多变量分析，评估无生化疾病（bNED）生存期（失败定义为PSA≥1.5 ng/ml且持续升高）。
前列腺特异性抗原倍增时间（PSADT）与放射剂量一样，是生存期的重要预测指标。治疗前PSADT＜12个月的患者在18个月时出现50%的失败，而PSADT未增加的患者在3年时仅出现3%的失败。
前列腺特异性抗原倍增时间（PSADT）是前列腺癌bNED结局的预测指标。PSADT＜12个月的患者疾病侵袭性强，应考虑采用多模式治疗。57%的患者观察到PSADT缓慢（≥5年），在决定观察而非治疗时可考虑这一终点。治疗失败后，PSADT可用于确定哪些患者不需要立即进行雄激素剥夺治疗。
