The role of PSA in the radiotherapy of prostate cancer.
Pretreatment prostate-specific antigen (PSA) level is the single most important prognostic factor for patients undergoing radiotherapy for clinically localized prostate cancer. When combined with Gleason score and T-stage, pretreatment PSA enhances our ability to accurately predict pathologic stage. Patients with pretreatment PSA levels > 10 ng/mL are at high risk for biochemical failure when treated with conventional radiation alone. A PSA nadir of > 1 ng/mL and a post-treatment PSA > 1.5 ng/mL are associated with a high risk of biochemical failure. Postoperative radiotherapy delivered while the tumor burden is low (eg, PSA < 1 ng/mL) predicts a favorable outcome. Many of these conclusions about the usefulness of pretreatment PSA are based on the assumption that PSA can be used as a surrogate end point for disease-free and overall survival from prostate cancer. However, this assumption still remains to be validated by phase III trials.
Roach
M
M
Radiation and Medical Oncology, University of California, San Francisco, USA.
D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology; D018572:Disease-Free Survival; D005544:Forecasting; D006801:Humans; D008297:Male; D009367:Neoplasm Staging / Q000379:methods; D016133:Polymerase Chain Reaction; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000532:radiotherapy*; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen