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

• Main Authors: Carlos Antônio da Silva Franca, Sérgio Lannes Vieira, Antonio Carlos Pires Carvalho, Antonio Jose Serrano Bernabe, Antonio Belmiro Rodrigues Campbell Penna
• Format: Article
• Language: English
• Published: Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 2014-04-01
• Series: Radiologia Brasileira
• Subjects: PSA nadir; Braquiterapia; Radioisótopos do iodo; Neoplasia de próstata
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842014000200010&lng=en&tlng=en

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.