Relationship between two year PSA nadir and biochemical
                    recurrence in prostate cancer patients treated with iodine-125
                        brachytherapy

Franca, Carlos Antônio da Silva; Vieira, Sérgio Lannes; Carvalho, Antonio Carlos Pires; Bernabe, Antonio Jose Serrano; Penna, Antonio Belmiro Rodrigues Campbell

doi:10.1590/S0100-39842014000200010

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Sumário

Original Articles • Radiol. Bras. 47 (2) • Mar-Apr 2014 • https://doi.org/10.1590/S0100-39842014000200010 copy

Relationship between two year PSA nadir and biochemical recurrence in prostate cancer patients treated with iodine-125 brachytherapy^* * Study developed at Radioterapia Botafogo, with support of Instituto Brasileiro de Oncologia (IBO), Universidade Federal do Rio de Janeiro (UFRJ) and Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To evaluate the relationship between two year PSA nadir (PSAn) after brachytherapy and biochemical recurrence rates in prostate cancer patients.

Materials and Methods

In the period from January 1998 to August 2007, 120 patients were treated with iodine-125 brachytherapy alone. The results analysis was based on the definition of biochemical recurrence according to the Phoenix Consensus.

Results

Biochemical control was observed in 86 patients (71.7%), and biochemical recurrence, in 34 (28.3%). Mean PSAn was 0.53 ng/ml. The mean follow-up was 98 months. The patients were divided into two groups: group 1, with two year PSAn < 0.5 ng/ml after brachytherapy (74 patients; 61.7%), and group 2, with two year PSAn ≥ 0.5 ng/ml after brachytherapy (46 patients; 38.3%). Group 1 presented biochemical recurrence in 15 patients (20.3%), and group 2, in 19 patients (43.2%) (p < 0.02). The analysis of biochemical disease-free survival at seven years, stratified by the two groups, showed values of 80% and 64% (p < 0.02), respectively.

Conclusion

Levels of two year PSAn ≥ 0.5 ng/ml after brachytherapy are strongly correlated with a poor prognosis. This fact may help to identify patients at risk for disease recurrence.

PSA nadir; Brachytherapy; Iodine radioisotopes; Prostatic neoplasms

	Group 1	Group 2	p
	Mean (CI95%)	Mean (CI95%)	p
Age (years)	68 (67–69)	66 (65–67)	0.13
PSAi (ng/ml)	10.7 (9.7–11.8)	11.2 (10–12.4)	0.4
Volume (g)	39.6 (37.9–41.2)	35 (33.4–36.6)	0.85
V₁₀₀ (%)	83.6 (81.7–85.6)	87.3 (84.8–89.8)	0.25
D₉₀ (%)	97.6 (95.3–100)	101 (97.8–104.3)	0.08
V₁₅₀ (%)	49.7 (47.3–52.1)	56.7 (54–59.3)	0.1
Risk groups	Patients (%)	Patients (%)
Low	11 (12.2%)	5 (16.7%)	0.3
Intermediate	52 (57.8%)	15 (50%)
High	27 (30%)	10 (33.3%)
PSAi
0–10 ng/ml	80 (88.8%)	25 (83.3%)	0.25
10.1–20 ng/ml	5 (5.6%)	3 (10%)
> 20 ng/ml	5 (5.6%)	2 (6.7%)
Clinical stage
T1c–T2a	16 (17.8%)	8 (26.7%)	0.06
T2b–T2c	74 (82.2%)	22 (73.3%)	0.06
Gleason score
2–6	80 (88.8%)	25 (83.3%)	0.25
7	5 (5.6%)	3 (10%)
8–9	5 (5.6%)	2 (6.7%)
NHT
Yes	46 (51%)	16 (53%)	0.52
No	44 (49%)	14 (47%)	0.52

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[1] Mailing Address: Dr. Carlos Antônio da Silva Franca. Rua Marechal Niemeyer, 16, Botafogo. Rio de Janeiro, RJ, Brazil, 22251-060. E-mail: carlosfranca@cremerj.org.br