Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer

Marcin Miszczyk; Łukasz Magrowski; Oliwia Masri; Iwona Jabłońska; Zuzanna Nowicka; Tomasz Krzysztofiak; Piotr Wojcieszek; Aleksandra Lipka-Rajwa; Jakub Ciepał; Gabriela Depowska; Krystyna Chimiak; Gabriela Bylica; Katarzyna Płoszka; Mateusz Łaszczych; Wojciech Majewski

doi:10.5114/jcb.2022.113546

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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abstract:

Original paper

Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer

Marcin Miszczyk

¹

,

Łukasz Magrowski

¹

,

Oliwia Masri

¹

,

Iwona Jabłońska

¹

,

Zuzanna Nowicka

²

,

Tomasz Krzysztofiak

³

,

Piotr Wojcieszek

³

,

Aleksandra Lipka-Rajwa

¹

,

Jakub Ciepał

¹

,

Gabriela Depowska

¹

,

Krystyna Chimiak

¹

,

Gabriela Bylica

¹

,

Katarzyna Płoszka

²

,

Mateusz Łaszczych

²

,

Wojciech Majewski

⁴

3rd Radiotherapy and Chemotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
Department of Biostatistics and Translational Medicine, Medical University of Lodz
Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Poland
Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland

J Contemp Brachytherapy 2022; 14, 1: 15–22

DOI: https://doi.org/10.5114/jcb.2022.113546

Online publish date: 2022/02/18

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AMA

Miszczyk M, Magrowski Ł, Masri O, et al. Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer. Journal of Contemporary Brachytherapy. 2022;14(1):15-22. doi:10.5114/jcb.2022.113546.

APA

Miszczyk, M., Magrowski, Ł., Masri, O., Jabłońska, I., Nowicka, Z.,  & Krzysztofiak, T. et al. (2022). Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer. Journal of Contemporary Brachytherapy, 14(1), 15-22. https://doi.org/10.5114/jcb.2022.113546

Chicago

Miszczyk, Marcin, Łukasz Magrowski, Oliwia Masri, Iwona Jabłońska, Zuzanna Nowicka, Tomasz Krzysztofiak,  and Piotr Wojcieszek et al. 2022. "Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer". Journal of Contemporary Brachytherapy 14 (1): 15-22. doi:10.5114/jcb.2022.113546.

Harvard

Miszczyk, M., Magrowski, Ł., Masri, O., Jabłońska, I., Nowicka, Z., Krzysztofiak, T., Wojcieszek, P., Lipka-Rajwa, A., Ciepał, J., Depowska, G., Chimiak, K., Bylica, G., Płoszka, K., Łaszczych, M.,  and Majewski, W. (2022). Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer. Journal of Contemporary Brachytherapy, 14(1), pp.15-22. https://doi.org/10.5114/jcb.2022.113546

MLA

Miszczyk, Marcin et al. "Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer." Journal of Contemporary Brachytherapy, vol. 14, no. 1, 2022, pp. 15-22. doi:10.5114/jcb.2022.113546.

Vancouver

Miszczyk M, Magrowski Ł, Masri O, Jabłońska I, Nowicka Z, Krzysztofiak T et al. Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer. Journal of Contemporary Brachytherapy. 2022;14(1):15-22. doi:10.5114/jcb.2022.113546.

Introduction
Serum prostate-specific antigen (PSA) kinetics has been linked to prognosis in prostate cancer (PCa) patients. Our goal was to analyze the association between PSA kinetics and metastasis-free survival (MFS) in patients with localized PCa treated with high-dose-rate (HDR) brachytherapy (BT) boost combined with external beam radiotherapy (EBRT).

Material and methods
We retrospectively analyzed multiple PSA kinetics related to PSA nadir (nPSA), PSA bouncing, and biochemical recurrence (BCR) in 186 PCa patients treated with neoadjuvant androgen deprivation therapy (ADT), followed by EBRT combined with HDR-BT boost. Uni- and multivariate Cox regression models were calculated to assess the value of PSA-related parameters for the prediction of MFS.

Results
5- and 10-year MFS were 95% and 84%, respectively. Median nPSA was 0.011 (IQR, 0.007-0.057) ng/ml and predicted MFS in multivariable analysis. Implementation of nPSA improved c-index of baseline model from 0.8 to 0.68. nPSA of 0.2 ng/ml offered the most optimal discriminatory ability for identifying patients with better prognoses. Time to nPSA (median, 11 months; IQR, 8-18 months) and PSA bounce, which occurred in 12.4% of patients, were not significantly associated with MFS.

Conclusions
Lower values of nPSA are significantly associated with decreased risk of developing metastases in patients treated with EBRT combined with HDR-BT boost and ADT, and improve the accuracy of a clinical model for MFS.

keywords:

Prostate-specific antigen kinetics and metastasis-free survival in patients treated with external beam radiotherapy combined with high-dose-rate brachytherapy boost and androgen deprivation therapy for localized prostate cancer

prostate cancer, radiotherapy, brachytherapy, PSA bounce, PSA nadir