Low-dose-rate prostate brachytherapy: 4–8 week postimplant prostate-specific antigen a novel predictor of biochemical failure-free survival

Publication date: Available online 24 August 2017
Source:Brachytherapy
Author(s): Cameron M. Callaghan, Lin Wang, Abhishek Alluri, Andrew Lauve, Cynthia Boyer, William Russell
PurposeThe purpose of this study was to determine the relationship between patient, disease, and treatment variables and biochemical failure-free survival (bFFS) following low-dose-rate prostate brachytherapy (LDR-BT).Methods and MaterialsData from 624 consecutive patients who received LDR-BT for localized prostate cancer between 2002 and 2012 at a single institution were collected for various patient, disease, and treatment characteristics including a 4–8 week postimplant PSA (4–8wkPSA). Subgroup analysis was stratified by risk category and treatment regimen. Analysis was performed using Kaplan–Meier survival curves, Cox proportional hazard ratios (HRs), and receiver-operator characteristic curves.ResultsA total of 624 consecutive patients were included with followup time of 4.0 ± 3.1 years. Predictors of bFFS included PSA nadir and 4–8wkPSA (HR = 2.48, p = 0.000 and HR = 1.24, p = 0.000, respectively) for total population. Diabetes mellitus (p = 0.026), chronic obstructive pulmonary disease (p = 0.000), alcohol use (p = 0.024), and age (p = 0.002) were predictors for specific subgroups. Receiver-operator characteristic curves 4–8wkPSA were found to be significant (p = 0.036).Conclusion4–8wkPSA is a novel predictor of bFFS for patients receiving LDR-BT across several risk categories and treatment regimens with potential clinical utility as a prognostic indicator. Certain comorbidities and exposure histories also demonstrated significant relationships with bFFS including chronic obstructive pulmonary disease, diabetes mellitus, age, alcohol history, proton pump inhibitor use, PSA nadir, and PSA density.



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