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Prostate‐specific antigen recurrence and mortality after conventional dose radiation therapy in select men with low‐risk prostate cancer
Author(s) -
Petit Joshua H.,
Chen MingHui,
Loffredo Marian,
Sussman Brenda,
Renshaw Andrew A.,
D'Amico Anthony V.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22243
Subject(s) - medicine , prostate cancer , prostate specific antigen , oncology , radiation therapy , cancer
BACKGROUND. Prostate‐specific antigen (PSA) recurrence, prostate cancer‐specific mortality (PCSM), and all‐cause mortality (ACM) were evaluated for men age >70 years receiving conventional dose external beam radiation therapy (RT). METHODS. Between January 1, 1989, and December 1, 2002, 358 men were treated with RT for localized prostate cancer at a Harvard Medical School Affiliate in Fall River, MA. Median age was 71.2 (range, 43.2–83.5) years and patients were followed for a median of 4.0 (range, 0.2–13.5) years. RESULTS. Univariable analysis demonstrated that increasing pretreatment PSA velocity was significantly associated with increasing pretreatment PSA ( P < .0001), Gleason score ( P = .0002), and shorter post‐RT PSA doubling time ( P = .0007) but not with clinical T‐category ( P = .09) or percent positive biopsies ( P = .08). For the select cohort of men age >70 years with low‐risk disease and a pretreatment PSA velocity ≤1.0 ng/mL per year, all deaths observed to date have been from nonprostate cancer etiologies. Whereas PSA recurrence in this group reached 43.3% by 7 years, due to the advanced age of the cohort and less aggressive biology, competing causes of mortality predominated as the cause of death despite PSA failure. CONCLUSIONS. In men age >70 years with low‐risk prostate cancer and pretreatment PSA velocity ≤1.0 ng/mL/year, prostate cancer death was not observed despite a modest PSA recurrence rate. Cancer 2006. © 2006 American Cancer Society.