Prostate-specific antigen bounce predicts for a favorable prognosis following brachytherapy: a meta-analysis.

Authors

Michael B Bernstein, Department of Radiation Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
Nitin Ohri, Thomas Jefferson UniversityFollow
James W Hodge, Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
Madhur Garg, Department of Radiation Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
William Bodner, Department of Radiation Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
Shalom Kalnicki, Department of Radiation Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NYFollow
Adam Dicker, MD, PhD, Thomas Jefferson UniversityFollow
Chandan Guha, Department of Radiation Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NYFollow

Document Type

Article

Publication Date

12-1-2013

Comments

This article has been peer reviewed. It was published in: Journal of Contemporary Brachytherapy.

Volume 5, Issue 4, November 2013, Pages 210-214.

The published version is available at DOI: 10.5114/jcb.2013.38875. Copyright © Termedia Sp

Abstract

PURPOSE: Controversy exists whether the prostate-specific antigen (PSA) bounce phenomenon following definitive radiation for prostate cancer has prognostic significance. Here, we perform a meta-analysis to determine the association between PSA bounce and biochemical control after brachytherapy alone.

MATERIAL AND METHODS: We reviewed Medline, EMBASE, and CENTRAL citations through February 2012. Studies that recorded biochemical failure rates in bouncers and non-bouncers were included. Hazard ratios describing the impact of bounce on biochemical failure were extracted directly from the studies or calculated from survival curves. Pooled estimates were obtained using the inverse variance method. A random effects model was used in cases of significant effect heterogeneity (p < 0.10 using Q test).

RESULTS: The final analysis included 3011 patients over 6 studies treated with brachytherapy. Meta-analysis revealed that patients experiencing PSA bounce after brachytherapy, conferred a decreased risk of biochemical failure (random effects model HR = 0.42, 95% CI: 0.30-0.59; p < 0.001).

CONCLUSIONS: Our meta-analysis determined that PSA bounce predicts for improved biochemical control following brachytherapy. To our knowledge, this is the first study describing this effect.

Recommended Citation

Bernstein, Michael B; Ohri, Nitin; Hodge, James W; Garg, Madhur; Bodner, William; Kalnicki, Shalom; Dicker, MD, PhD, Adam; and Guha, Chandan, "Prostate-specific antigen bounce predicts for a favorable prognosis following brachytherapy: a meta-analysis." (2013). Department of Radiation Oncology Faculty Papers. Paper 44.
https://jdc.jefferson.edu/radoncfp/44

PubMed ID

24474969