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Time and PSA threshold model prognosticates long-term overall and disease-specific survival in prostate cancer patients as early as 3 months after external beam radiation therapy

Prostate Cancer and Prostatic Diseases volume 8, pages 353–358 (2005)Cite this article

Abstract

The specific aim of this analysis was to evaluate the capability of a time and prostate-specific antigen (PSA) threshold model to prognosticate overall survival (OS) and disease-specific survival (DSS) based on early PSA kinetics after radiotherapy for prostate cancer by retrospective review of outcomes in 918 patients. Crossing below analyzed PSA thresholds at specific defined time points reduced disease-specific death hazard ratios to relative to the cohort above threshold. The time and PSA threshold model demonstrates the ability to prognosticate OS and DSS as early as 3 months post-radiotherapy for prostate cancer.

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References

  1. Carducci MA, DeWeese TL, Nelson JB . Prostate-specific antigen and other markers of therapeutic response. Urol Clin N Am 1999; 26: 291–302, viii.

    Article  CAS  Google Scholar 

  2. Montie JE . Follow-up after radical prostatectomy or radiation therapy for prostate cancer. Urol Clin N Am 1994; 21: 673–676.

    CAS  Google Scholar 

  3. American Society for Therapeutic Radiology and Oncology Consensus Panel. Consensus statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 1997; 37: 1035–1041.

  4. Small EJ, Roach III M . Prostate-specific antigen in prostate cancer: a case study in the development of a tumor marker to monitor recurrence and assess response. Semin Oncol 2002; 29: 264–273.

    Article  CAS  Google Scholar 

  5. Taylor JM, Griffith KA, Sandler HM . Definitions of biochemical failure in prostate cancer following radiation therapy. Int J Radiat Oncol Biol Phys 2001; 50: 1212–1219.

    Article  CAS  Google Scholar 

  6. Kattan MW, Fearn PA, Leibel S, Potters L . The definition of biochemical failure in patients treated with definitive radiotherapy. Int J Radiat Oncol Biol Phys 2000; 48: 1469–1474.

    Article  CAS  Google Scholar 

  7. Hanlon AL, Hanks GE . Scrutiny of the ASTRO consensus definition of biochemical failure in irradiated prostate cancer patients demonstrates its usefulness and robustness. American Society for Therapeutic Radiology and Oncology. Int J Radiat Oncol Biol Phys 2000; 46: 559–566.

    Article  CAS  Google Scholar 

  8. Lee WR, Hanlon AL, Hanks GE . Prostate specific antigen nadir following external beam radiation therapy for clinically localized prostate cancer: the relationship between nadir level and disease-free survival. J Urol 1996; 156 (Part 1): 450–453.

    CAS  PubMed  Google Scholar 

  9. Thames H et al. Comparison of alternative biochemical failure definitions based on clinical outcome in 4839 prostate cancer patients treated by external beam radiotherapy between 1986 and 1995. Int J Radiat Oncol Biol Phys 2003; 57: 929–943.

    Article  CAS  Google Scholar 

  10. D'Amico AV et al. Surrogate end point for prostate cancer-specific mortality after radical prostatectomy or radiation therapy. J Natl Cancer Inst 2003; 95: 1376–1383.

    Article  Google Scholar 

  11. Cavanaugh SX et al. Early prostate-specific antigen (PSA) kinetics following prostate carcinoma radiotherapy: Prognostic value of a time-and-PSA threshold model. Cancer 2004; 101: 96–105.

    Article  Google Scholar 

  12. Dawson NA . Response criteria in prostatic carcinoma. Semin Oncol 1999; 26: 174–184.

    CAS  PubMed  Google Scholar 

  13. D'Amico AV et al. Determinants of prostate cancer specific survival following radiation therapy during the prostate specific antigen era. J Urol 2003; 170 (Part 2): S42–S46; discussion S46–S47.

    PubMed  Google Scholar 

  14. Sandler HM, DeSilvio ML . Surrogate end points for prostate cancer: what is prostate-specific antigen telling us? J Natl Cancer Inst 2003; 95: 1352–1353.

    Article  Google Scholar 

  15. Sartor O . Endpoints in prostate cancer clinical trials. Urology 2002; 60 (Suppl 1): 101–107; discussion 107–108.

    Article  Google Scholar 

  16. Pollack A et al. Prostate biopsy status and PSA nadir level as early surrogates for treatment failure: analysis of a prostate cancer randomized radiation dose escalation trial. Int J Radiat Oncol Biol Phys 2002; 54: 677–685.

    Article  Google Scholar 

  17. D'Amico AV et al. Utilizing predictions of early prostate-specific antigen failure to optimize patient selection for adjuvant systemic therapy trials. J Clin Oncol 2000; 18: 3240–3246.

    Article  CAS  Google Scholar 

  18. Swindle PW, Kattan MW, Scardino PT . Markers and meaning of primary treatment failure. Urol Clin N Am 2003; 30: 377–401.

    Article  Google Scholar 

  19. Kavadi VS, Zagars GK, Pollack A . Serum prostate-specific antigen after radiation therapy for clinically localized prostate cancer: prognostic implications. Int J Radiat Oncol Biol Phys 1994; 30: 279–287.

    Article  CAS  Google Scholar 

  20. Critz FA et al. Prostate-specific antigen nadir of 0.5 ng/ml or less defines disease freedom for surgically staged men irradiated for prostate cancer. Urology 1997; 49: 668–672.

    Article  CAS  Google Scholar 

  21. Bagshaw MA, Ray GR, Cox RS . Radiotherapy of prostatic carcinoma: long- or short-term efficacy (Stanford University experience). Urology 1985; 25 (Suppl): 17–23.

    CAS  PubMed  Google Scholar 

  22. Prentice RL . Surrogate endpoints in clinical trials: definition and operational criteria. Stat Med 1989; 8: 431–440.

    Article  CAS  Google Scholar 

  23. Buyse M, Molenberghs G . Criteria for the validation of surrogate endpoints in randomized experiments. Biometrics 1998; 54: 1014–1029.

    Article  CAS  Google Scholar 

  24. Molenberghs G et al. Statistical challenges in the evaluation of surrogate endpoints in randomized trials. Control Clin Trials 2002; 23: 607–625.

    Article  Google Scholar 

  25. Molenberghs G, Burzykowski T, Alonso A, Buyse M . A perspective on surrogate endpoints in controlled clinical trials. Stat Methods Med Res 2004; 13: 177–206.

    Article  Google Scholar 

  26. Verbel DA, Heller G, Kelly WK, Scher HI . Quantifying the amount of variation in survival explained by prostate-specific antigen. Clin Cancer Res 2002; 8: 2576–2579.

    PubMed  Google Scholar 

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Acknowledgements

Mr Fuller was supported by a grant from the NIH/NCRR/Frederic C Bartter GCRC-Mentored Medical Student Clinical Research Program (NIH M01-RR01346). Preliminary data from this work were presented at the meeting of the German Society for Radiation Oncology (DEGRO), in Erfurt, Germany, June 2004.

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Authors and Affiliations

  1. Departmnet of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA

    S X Cavanaugh, C D Fuller & M Fuss

  2. Division of Radiological Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA

    S X Cavanaugh

  3. Department of Radiation Oncology, MD Anderson Cancer Center Orlando, Orlando, Florida, USA

    P A Kupelian

  4. Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio, USA

    P A Kupelian & C Reddy

  5. Center for Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio and San Antonio Cancer Institute, San Antonio, Texas, USA

    P Bradshaw & B H Pollock

Authors
  1. S X Cavanaugh
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  2. C D Fuller
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  3. P A Kupelian
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  4. C Reddy
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  5. P Bradshaw
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  6. B H Pollock
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  7. M Fuss
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Correspondence to S X Cavanaugh.

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Cavanaugh, S., Fuller, C., Kupelian, P. et al. Time and PSA threshold model prognosticates long-term overall and disease-specific survival in prostate cancer patients as early as 3 months after external beam radiation therapy. Prostate Cancer Prostatic Dis 8, 353–358 (2005). https://doi.org/10.1038/sj.pcan.4500831

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  • DOI: https://doi.org/10.1038/sj.pcan.4500831

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