Low‐Dose‐Rate Prostate Brachytherapy (LDR‐PB) adopts postsurgical PSA value for definition of cure

• Published in: BJUI compass Vol. 2; no. 1; pp. 9 - 10
• Main Authors: Uribe, Jennifer, Uribe‐Lewis, Santiago, Khaksar, Sara, Perna, Carla, Mikropoulos, Christos, Otter, Sophie, Laing, Robert, Langley, Stephen
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2021; John Wiley and Sons Inc
• Subjects: Cancer therapies; Prostate cancer; Radiation therapy; Survival analysis; Transplants & implants
• ISSN: 2688-4526; 2688-4526
• DOI: 10.1002/bco2.49

Long-term remission, and likely cure, of clinically localized prostate cancer is considered when there is no evidence of prostate-specific antigen (PSA) or radiographic progression 10 years after initial localized therapy. 1 The PSA level thresholds to define the posttreatment (biochemical) progression differ based on the mechanism of action of a surgical or radiotherapeutic approach, making cross-modality comparisons cumbersome. Kaplan-Meier analyses showed overall 10- and 15-year FFR rates of 98% and 95% in patients with a 48-month PSA ≤ 0.2 ng/mL (Figure 1); multivariable Cox proportional hazards regression, 5 adjusted for age at treatment, risk classification, and treatment modalities (including the use of ADT), indicated survival rates were not dependent on these predictor variables in patients with a 48-month PSA ≤ 0.2 ng/mL. Kaplan-Meier relapse-free survival analysis of patients who received LDR-PB (alone or as combination with ADT and/or EBRT) stratified by their PSA value (ng/mL) 48 months post-implant Previously we reported that 92% of relapse-free high-risk patients with an available PSA 10 years after implantation had a PSA level ≤ 0.2 ng/mL. 6 Therefore, from our own long-term experience and that of others, adoption of a PSA value of ≤ 0.2 ng/mL at 48 months posttreatment as a biochemical definition of cure for patients treated with LDR-PB is reasonable and evidence based.