Cancer Treatment Reviews
Volume 24, Issue 2 , Pages 91-99 , April 1998

Prognostic value of prostate specific antigen before, during and after radiotherapy

  • M. Reni

      Affiliations

    • Corresponding Author InformationCorrespondence to: M. Reni, Department of Radiochemotherapy, San Raffaele Hospital, via Olgettina 60, 20132 Milan, Italy.
    • ,
  • A. Bolognesi

References 

  1. Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E. PSA as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987;317:909–916
  2. Fijuth J, Chauvet B, Vincent P, Felix-Faure C, Reboul F. Serum PSA in monitoring the response of carcinoma of the prostate to radiation therapy. Radiother Oncol. 1992;23:236–240
  3. Eisenberg MA, Nelson WG. How much can we rely on the level of PSA as an endpoint for evaluation of clinical trials?. In: A word of caution!. 4th edition. J Natl Cancer Inst. 88:1997;p. 9–11
  4. Kaplan ID, Cox RS, Bagshaw MA. PSA after external beam radiotherapy for prostate cancer: follow-up. J Urol. 1993;149:519–522
  5. Russell KJ, Dunatov C, Hafermann MD, et al.  PSA in the management of patients with localized adenocarcinoma of the prostate treated with primary radiation therapy. J Urol. 1991;146:1046–1052
  6. Zagars GK. Serum PSA as a tumor marker for patients undergoing definitive radiation therapy. Urol Clin N Am. 1993;20:737–747
  7. Schneider SB, Schweitzer VG, Parker RG, Bycott PW. The prognostic value of PSA in prostate cancer treated with primary radiation: the UCLA experience 1988–1992. In: 4th edition. Proc ASCO. 36:1995;p. A3840
  8. Zagars GJ, Sherman NE, Babajan RJ. PSA and external beam radiation therapy in prostate cancer. Cancer. 1991;67:412–420
  9. Meek AG, Park TL, Oberman E, Wielopsloki L. A prospective study of PSA levels in patients receiving radiotherapy for localized carcinoma of the prostate. Int J Radiat Oncol Biol Phys. 1990;19:733–741
  10. Schellhammer PF, Schlossberg SM, el Mahdi AM, Wright GL, Brassil DN. PSA levels after definitive irradiation for carcinoma of the prostate. J Urol. 1991;145:1008–1010
  11. Pisansky TM, Cha SS, Earle JD, et al.  PSA as a pretherapy prognostic factor in patients treated with radiation therapy for clinically localized prostate cancer. J Clin Oncol. 1993;11:2158–2166
  12. Russell KJ, Boileau MA. Current status of PSA in the radiotherapeutic management of prostatic cancer. Semin Radiat Oncol. 1993;3:154–168
  13. Zagars GK, Pollack A, von Eschenbach AC. Prostate cancer and radiation therapy—the message conveyed by serum prostate-specific antigen. Int J Radiat Oncol Biol Phys. 1995;33:23–35
  14. Ritter MA, Messing EM, Shanahan TG, Potts S, Chappel RJ, Kinsella TJ. PSA as a predictor of radiotherapy response and patterns of failure in localized prostate cancer. J Clin Oncol. 1992;19:1208–1217
  15. Zagars GK. PSA as a prognostic factor for prostate cancer treated by external beam radiotherapy. Int J Radiat Oncol Biol Phys. 1992;23:47–53
  16. Zagars GK, von Eschenbach AC. PSA: an important maker for prostate cancer treated by external beam radiotherapy. Cancer. 1993;72:538–548
  17. Zietman AL, Coen JJ, Shipley WU, Willet CG, Efird JT. Radical radiation therapy in the management of prostatic adenocarcinoma: the initial PSA value as a predictor of treatment outcome. J Urol. 1994;151:640–645
  18. Lee WR, Hanks GE, Schultheiss TE, Corn BW, Hunt MA. Localized prostate cancer treated by external beam radiotherapy alone: serum PSA driven outcome analysis. J Clin Oncol. 1995;13:464–469
  19. Chauvet B, Félix-Faure C, Lupsascka N, et al.  PSA decline: a major prognostic factor for prostate cancer treated with radiation therapy. J Clin Oncol. 1994;12:1402–1407
  20. Landmann C, Hunig R. PSA as an indicator of response to radiotherapy in prostate cancer. Int J Radiat Oncol Biol Phys. 1989;17:1073–1076
  21. Dundas GS, Porter AT, Venner PM. PSA. In: Monitoring the response of carcinoma of the prostate to radiotherapy with a new tumor marker. 4th edition. Cancer. 66:1990;p. 45–48
  22. Schneider SB, Schweitzer VG, Parker RG, Bycott PW. The prognostic value of PSA levels in radiation therapy of patients with carcinoma of the prostate: the UCLA experience 1988–1992. Am J Clin Oncol. 1996;19:65–72
  23. Critz FA, Tarlton RS, Holladay DA. PSA monitored combination radiotherapy for patients with prostate cancer. Cancer. 1995;75:2383–2391
  24. Kuban DA, el-Mahdi AM, Schellhammer PF. PSA for pretreatment prediction and posttreatment evaluation of outcome after definitive irradiation for prostate cancer. Int J Radiat Oncol Biol Phys. 1995;32:307–316
  25. Zagars GK, Pollack A, Kavadi VS, von Eschenbach AC. PSA and radiation therapy for clinically localized prostate cancer. Int J Radiat Oncol Biol Phys. 1995;32:293–306
  26. Babaian RJ, Kojima M, Saitoh M, Ayala AG. Detection of residual prostate cancer after external radiotherapy. Cancer. 1995;75:2153–2158
  27. Hanks GE, Hanlon AL, Hudes G, Lee WR, Suasin W, Schultheiss TE. Patterns of failure analysis of patients with high pretreatment PSA levels treated by radiation therapy: the need for improved systemic and locoregional treatment. J Clin Oncol. 1996;14:1093–1097
  28. Geara FB, Zagars GK, Pollack A. Influence of initial presentation on treatment outcome of clinically localized prostate cancer treated by definitive radiation therapy. Int J Radiat Oncol Biol Phys. 1994;30:331–337
  29. Lee WR, Hanks GE, Corn BW, Schultheiss TE. Observation of pretreatment PSA doubling time in 107 patients referred for definitive radiotherapy. Int J Radiat Oncol Biol Phys. 1995;31:21–24
  30. Vijayakumar S, Quadri SF, Karrison TG, et al.  Localized prostate cancer: use of serial PSA measurements during radiation therapy. Radiology. 1992;184:271–274
  31. Vijayakumar S, Quadri SF, Sen S, Vaida F, Ignacio L, Weichselbaum RR. Measurement of weekly PSA levels in patients receiving pelvic radiotherapy for nonprostatic malignancies. Int J Radiat Oncol Biol Phys. 1995;32:189–195
  32. Oesterling JE, Chan DW, Epstein JI, et al.  PSA in the preoperative and postoperative evaluation of localized prostatic cancer treated with radical prostatectomy. J Urol. 1988;139:766–772
  33. Bostwick DG, Egbert BM, Fajardo LF. Radiation injury of the normal and neoplastic prostate. Am J Surg Pathol. 1982;6:541–551
  34. Cox JD, Stoffel TJ. The significance of needle biopsy after irradiation for stage C adenocarcinoma of the prostate. Cancer. 1977;40:156–160
  35. Kaplan ID, Cox RS, Bagshaw MA. A model of prostatic carcinoma tumor kinetics based on PSA levels after radiation therapy. Cancer. 1991;68:400–405
  36. Zagars GK, Pollack A. The fall and rise of PSA: kinetics of serum PSA levels after radiation therapy for prostate cancer. Cancer. 1993;72:832–842
  37. Willet CG, Zietman AL, Shipley WU, Coen JJ. The effect of pelvic radiation on serum levels of PSA. J Urol. 1994;151:1579–1581
  38. Kinsella TJ, Frass BA, Glatstein E. Late effects of radiation therapy in the treatment of Hodgkin's disease. Cancer Treat Rep. 1982;66:991–995
  39. Valdez IH, Atkinson JC, Ship JA, Fox PC. Major salivary function in patients with radiation induced xerostomia: flow rates and sialochemistry. Int J Radiat Oncol Biol Phys. 1993;25:41–48
  40. Duffner PK, Cohen ME, Voorhess ML, et al.  Long term effects of cranial irradiation on endocrine function in children with brain tumors. Cancer. 1985;56:2189–2194
  41. Meyer JS. Potential value of cell kinetics in management of cancers of unknown origin. Semin Oncol. 1982;9:513–516
  42. Helpap B, Stiens R, Bruhl P. The proliferative pattern of the prostatic carcinoma before and under hormonal treatment. Z Krebsforsch. 1976;87:311–320
  43. Scrivner DL, Meyer JS, Rujanavech N, Fathman A, Schully T. Cell kinetics by bromodeoxyuridine labeling and deoxyribonucleic acid ploidy in prostatic carcinoma needle biopsies. J Urol. 1991;146:1034–1039
  44. Nemoto R, Uchida K, Shimazuni T, Hattori K, Koiso K, Harada M. Immunocytochemical demonstration of S phase cells by antibromodeoxyuridine monoclonal antibody in human prostate adenocarcinoma. J Urol. 1989;141:337–340
  45. Charbit A, Malaise EP, Tubiana M. Relation between the pathological nature and the growth rate of human tumors. Eur J Cancer. 1971;7:307–315
  46. Perez C. Presidential address of the 24th Annual Meeting of the American Society of Therapeutic Radiologists. In: Carcinoma of the prostate: a vexing biological and clinical enigma. 4th edition. Int J Radiat Oncol Biol Phys. 9:1983;p. 1427–1438
  47. Zagars GK, von Eschenbach AC, Johnson DE, Oswald MJ. Stage C adenocarcinoma of the prostate: an analysis of 551 patients treated with external beam radiation. Cancer. 1987;60:1489–1499
  48. Cox JD, Kline RW. The lack of prognostic significance of biopsies after radiotherapy for prostatic cancer. Semin Urol. 1983;1:237–242
  49. Kavadi VS, Zagars GK, Pollack A. Serum PSA after radiation therapy for clinically localized prostate cancer: prognostic implications. Int J Radiat Oncol Biol Phys. 1994;30:279–287
  50. Caccia G, Delfino C, Bosch B, Maniago O, Di Nucci M. Prognostic factors in patients treated with radiation therapy for loco-regionally confined prostatic cancer. In: 4th edition. Proc ASCO. 14:1995;p. A1637
  51. Zagars GK, Pollack A. The serum PSA level three months after radiotherapy for prostate cancer: an early indicator of response to treatment. Radiother Oncol. 1994;30:121–127
  52. Zagars GK. The prognostic significance of a single serum PSA value beyond six months after radiation therapy for adenocarcinoma of the prostate. Int J Radiat Oncol Biol Phys. 1993;27:39–45
  53. Crook JM, Perry GA, Robertson S, Esche BA. Routine prostate biopsies following radiotherapy for prostate cancer: results for 226 patients. Urology. 1995;45:624–631
  54. Critz FA, Levinson K, Williams WH, Holladay DA. PSA nadir: the optimum level after irradiation for prostate cancer. J Clin Oncol. 1996;14:2893–2900
  55. Tibbs MK, Zietman AL, Dallow KC, Althausen AF, Heney NM, Shipley WU. Biochemical outcome following external beam radiation therapy for T1–2 prostate carcinoma: the importance of achieving an undetectable nadir PSA. Int J Radiat Oncol Biol Phys. 1995;32:230; (abstract 1016)
  56. Zelefsky MJ, Leibel SA, Wallner KE, Whitmore FW, Fuks Z. Significance of normal serum PSA in the follow-up period after definitive radiation therapy for prostatic cancer. J Clin Oncol. 1995;13:359–463
  57. Frazier HA, Robertson JE, Humphrey PA, Paulson DF. Is PSA of clinical importance in evaluating outcome after radical prostatectomy?. J Urol. 1993;149:516–518
  58. Partin AW, Pound CR, Clemens JQ, Epstein JI, Walsh PC. Serum PSA after anatomic radical prostatectomy. In: The John Hopkins experience after 10 years. 4th edition. Urol Clin N Am. 20:1993;p. 713–725
  59. Stein A, DeKernion JB, Smith RB, Dorey F, Patel H. PSA levels after radical prostatectomy in patients with organ confined and locally extensive prostate cancer. J Urol. 1992;147:942–946
  60. Zagars GK, Kavadi VS, Pollack A, von Eschenbach AC, Sands ME. The source of pretreatment serum PSA in clinically localized prostate—T, N, or M?. Int J Radiat Oncol Biol Phys. 1995;32:21–32
  61. Wallner K, Roy J, Zelefsky M, Fuks Z, Harrison L. Shortterm freedom from disease progression after 125I prostate implantation. Int J Radiat Oncol Biol Phys. 1994;30:405–409
  62. Stamey TA, Kabalin JN, Ferrari M. PSA in the diagnosis and treatment of adenocarcinoma of the prostate. III. Radiation treated patients. J Urol. 1989;141:1084–1087
  63. Mameghan H, Fisher RJ, De Souza P. The prognostic value of PSA after radiotherapy for prostate cancer. Br J Cancer. 1995;72(Suppl. XXV):6; (abstract O10)
  64. D'Amico AV, Whittington R, Malkowicz SB, Schultz D. A method for determining a PSA cure after radiation therapy for clinically localized prostate cancer. Int J Radiat Oncol Biol Phys. 1995;32:473–477
  65. Leibel SA, Zelefsky MJ, Kutcher GJ, Burman CN, Kelson F, Fuks Z. Three dimensional conformal radiation therapy in localized carcinoma of the prostate: interim report of phase I dose-escalation study. J Urol. 1994;152:1792–1798
  66. Zietman AL, Coen JJ, Dallow KC, Shipley WU. The treatment of prostate cancer by conventional radiation therapy: an analysis of long term outcome. Int J Radiat Oncol Biol Phys. 1995;32:287–292
  67. Horwitz EM, Vicini FA, Ziaja EL, et al.  Assessing the variability of outcome for patients treated with localized prostate irradiation using different definitions of biochemical control. Int J Radiat Oncol Biol Phys. 1996;36:565–571
  68. Hanks GE, D'Amico A, Epstein BE, Schulteiss TE. PSA doubling times in patients with prostate cancer: a potentially useful reflection of tumor doubling time. Int J Radiat Oncol Biol Phys. 1993;27:125–127
  69. Lee WR, Hanks GE, Hanlon A. Increasing PSA profile following definitive radiation therapy for localized prostate cancer: clinical observation. J Clin Oncol. 1997;15:230–238
  70. D'Amico A, Hanks GE. Linear regressive analysis using PSA doubling time for predicting tumor biology and clinical outcome in prostate cancer. Cancer. 1993;72:2638–2643
  71. Kaplan I, Prestidge BR, Cox RS, Bagshaw MA. PSA after irradiation for prostatic carcinoma. J Urol. 1990;144:1172–1175
  72. Pollack A, Zagars GK, Kavadi VS. PSA doubling time and disease relapse after radiotherapy for prostate cancer. Cancer. 1994;74:670–678
  73. Killian CS, Yang N, Emrich LJ, et al.  Prognostic importance of PSA for monitoring patients with stages B2 to D1 prostate cancer. Cancer Res. 1985;45:886–891
  74. Zagars GK. PSA as an outcome variable for T1 and T2 prostate cancer treated by radiation therapy. J Urol. 1994;152:1786–1791
  75. Kabalin JN, Hodge KK, McNeal JE, Freiha FS, Stamey TA. Identification of residual cancer in the prostate following radiation therapy: role of transrectal ultrasound guided biopsy and PSA. J Urol. 1989;142:326–331
  76. Dugan TC, Shipley WU, Young RH, et al.  Biopsy after external beam radiation therapy for adenocarcinoma of the prostate: correlation with initial histological grade and current PSA levels. J Urol. 1991;146:1313–1316
  77. Prestidge BR, Hoak DC, Grimm PD, Ragde H, Cavanagh W, Blasko JC. Posttreatment biopsy results following interstitial brachytherapy in early-stage prostate cancer. Int J Radiat Oncol Biol Phys. 1997;37:31–39
  78. Cox JD, Kline RW. Do prostate biopsies 12 months or more after external irradiation for adenocarcinoma, stage III, predict long term survival?. Int J Radiat Oncol Biol Phys. 1983;9:299–303
  79. Kagan AR, Gordon J, Cooper JF, Gilbert H, Nussbaum H, Chan P. A clinical appraisal of post-irradiation biopsy in prostatic cancer. Cancer. 1977;39(2):637–641
  80. Kiesling VJ, McAninch JW, Goebel JL. External beam radiotherapy for adenocarcinoma of the prostate: a clinical follow-up. J Urol. 1980;124:851–854
  81. Leach GE, Cooper JF, Kagan AR, Snyder R, Forsythe A. Radiotherapy for prostatic carcinoma: posttirradiation prostatic biopsy and recurrent patterns with long term follow-up. J Urol. 1982;128:505–509
  82. van der Werf-Messing B. Prostatic cancer treated at the Rotterdam Radiotherapy Institute. Strahlentherapie. 1978;154(8):537–541
  83. Perez CA. Carcinoma of the prostate. In:  Perez CA,  Brady LW editor. Principles and Practice of Radiation Oncology. Philadelphia: J.B. Lippincott; 1987;p. 867–898
  84. Carlton CE, Dawould F, Hudgins P, Scott R. Irradiation treatment of carcinoma of the prostate: a preliminary report based on 8 years of experience. J Urol. 1972;18:924–927
  85. Freiha FS, Bagshaw MA. Carcinoma of the prostate: results of post-irradiation biopsy. Prostate. 1984;5:19–25
  86. Scardino PT, Frankel JM, Wheeler TM, et al.  The prognostic significance of post-irradiation biopsy results in patients with prostatic cancer. J Urol. 1986;135:510–516
  87. Schellhammer PF, el-Mahdi AM, Higgins EM, Schultheiss TE, Ledaga LE, Babb TJ. Prostate biopsy after definitive treatment by interstitial 125iodine implant or external beam radiation therapy. J Urol. 1987;137:897–901
  88. Bailar JCI, Byar DP. Estrogen treatment for cancer of the prostate. In: Early results with 3 doses of diethylstilbestrol and placebo. 4th edition. Cancer. 26:1970;p. 257–261
  89. Byar DP. The Veterans Administration Cooperative Urologic Research Group's studies of cancer of the prostate. Cancer. 1973;32:1126–1130
  90. Byar DP, Green SB. The choice of treatment for cancer patients based on covariate information. Bull Cancer. 1980;67:477–490
  91. Prout GR, Keating MA, Griffin PP, Schiff SF. Long term experience with flutamide in patients with prostatic carcinoma. Urology. 1989;34:37–45 (Suppl.)
  92. Crawford ED, Eisenberger MA, McLeod DG, et al.  A controlled trial of leuprolide with and without flutamide in prostatic carcinoma. N Engl J Med. 1989;321:419–424
  93. Zincke H. Extended experience with surgical treatment of stage D1 adenocarcinoma of the prostate. In: Significant influences of immediate hormonal treatment (orchiectomy) on outcome. 4th edition. Urology. 33:1989;p. 27–36 (Suppl.)
  94. Zagars GK, Johnson DE, von Eschenbach AC, Hussey DH. Adjuvant estrogen following radiation therapy for stage C adenocarcinoma of the prostate: long-term results of a prospective randomized study. Int J Radiat Oncol Biol Phys. 1988;14:1085–1091

PII: S0305-7372(98)90075-5

Cancer Treatment Reviews
Volume 24, Issue 2 , Pages 91-99 , April 1998

Article Tools