Relationship between two year PSA nadir and biochemical recurrence in prostate cancer patients treated with iodine-125 brachytherap.
OBJECTIVE
To evaluate the relationship between two year PSA nadir (PSAn) after brachytherapy and biochemical recurrence rates in prostate cancer patients.


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.


CONCLUSIONS
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.
Master, MD, Radiation Oncology at Instituto Brasileiro de Oncologia (IBO), Radioterapia Botafogo, Universidade Federal do Rio de Janeiro (UFRJ) and Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil.
Carlos Antônio da Silva
CA
Franca
Full Professor, MD, Radiation Oncology at Instituto Brasileiro de Oncologia (IBO), Radioterapia Botafogo and Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil.
Sérgio Lannes
SL
Vieira
PhD, Professor at Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Antonio Carlos Pires
AC
Carvalho
MD, Urologist at Radioterapia Botafogo, Rio de Janeiro, RJ, Brazil.
Antonio Jose Serrano
AJ
Bernabe
PhD, MD, Radiation Oncology at Instituto Brasileiro de Oncologia (IBO), Radioterapia Botafogo and Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil.
Antonio Belmiro Rodrigues Campbell
AB
Penna
Brachytherapy; Iodine radioisotopes; PSA nadir; Prostatic neoplasms