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Prostate‐specific antigen half‐life and pretreatment prostate‐specific antigen: Crucial predictors for prostate‐specific antigen trend in delayed‐combined androgen blockade therapy
Author(s) -
Soga Norihito,
Onishi Takehisa,
Arima Kiminobu,
Sugimura Yoshiki
Publication year - 2007
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2007.01671.x
Subject(s) - medicine , prostate cancer , androgen , prostate specific antigen , urology , prostate , blockade , antigen , testosterone (patch) , castration , cancer , hormone , immunology , receptor
Purpose: To elucidate the crucial predictors for prostate‐specific antigen (PSA) trends and determine the usage of anti‐androgen treatment during delayed‐combined androgen blockade (CAB) leading to a PSA level below 0.2 ng/mL. Materials and Methods: From January 2001 to December 2004, 105 prostate cancer patients were enrolled. Medical castration and anti‐androgen treatment were used sequentially and termed delayed‐CAB. The first goal was to maintain an undetectable PSA level. The nadir PSA was determined after medical castration only. Anti‐androgen was given if a PSA level of more than 0.2 ng/mL was observed and the subsequent PSA response was assessed. All cases were divided into two groups based on whether the PSA was lower ( n = 59) or higher ( n = 46) than 0.2 ng/mL. An analysis of the difference between the two groups was calculated. Results: The median of the initial PSA level in the lower group was lower than in the higher group with a 95% cut‐off level of 40 ng/mL. The median PSA half‐life in the lower group was also reduced with a 95% cut‐off of 3.6 months. In a multivariate analysis, the pretreatment PSA level and the PSA half‐life exhibited a significant correlation between the two groups. Anti‐androgen treatment was given to 26 cases in the higher group. The PSA increased in one case, decreased to less than 0.2 ng/mL in 17 cases and remained over 0.2 ng/mL in eight cases. Conclusion: Both the PSA half‐life and the pretreatment PSA level were useful markers for predicting the PSA trends to determine the optimal use of anti‐androgen treatment during delayed‐CAB.