Andrea Gaetano Allegra, Luca Nicosia, Alessandro Molinari, Chiara De-Colle, Christian Fierro, Niccolò Giaj-Levra, Francesca Giannetti, Claudia Menichelli, Carolina Orsatti, Gabriella Pastore, Edoardo Pastorello, Francesco Ricchetti, Michele Rigo, Andrea Romei, Paola Zuccoli, Alessandro Fanelli, Filippo Alongi
{"title":"前列腺特异性抗原（PSA）降低作为根治性放射治疗中低、有利前列腺癌生化复发的预测因子。","authors":"Andrea Gaetano Allegra, Luca Nicosia, Alessandro Molinari, Chiara De-Colle, Christian Fierro, Niccolò Giaj-Levra, Francesca Giannetti, Claudia Menichelli, Carolina Orsatti, Gabriella Pastore, Edoardo Pastorello, Francesco Ricchetti, Michele Rigo, Andrea Romei, Paola Zuccoli, Alessandro Fanelli, Filippo Alongi","doi":"10.1007/s12094-025-03884-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Radiation therapy (RT) is standard treatment for localized prostate cancer (PCa). Prostate-specific antigen (PSA) kinetics, particularly PSA reduction (PSAr) after RT, are emerging as significant prognostic indicators for biochemical control. This retrospective multi-institutional study explores the correlation between PSAr and biochemical relapse-free survival (BRFS). This retrospective multi-institutional study explores the correlation between PSAr and biochemical relapse-free survival (BRFS).</p><p><strong>Methods: </strong>251 low-to-intermediate risk PCa patients treated with RT only were analyzed. Isoeffective RT schedules were: 39 fractions × 2 Gy, 28 × 2.55 Gy, 16 × 3.5 Gy, 5 × 7 Gy. Main objective was BRFS, defined as the time from PSA nadir (PSAn) to PSAn plus 2 ng/ml. PSAr was defined as the percentage of total PSA reduction from baseline. The optimal PSAr cut-off value was defined as 90%. Patients were stratified by PSAr, baseline PSA, Gleason Score (GS), and RT schedules.</p><p><strong>Results: </strong>GS was 3 + 3 in 120 (48%) patients and 3 + 4 in 131 (52%) patients. After a median follow-up of 36 months (30-48), 2 and 5-year BRFS were 97.3% and 95.2%, respectively, in patients with PSAr ≥ 90% and 89.5%, 61.5% in patients with PSAr < 90% (p = 0.00). In the responder population, median time to PSAr 90% was 24 months and the median time to PSAn was 28.7 months (20-38). At univariate and multivariate analyses, PSAr was the only significant predictor of BRFS [HR 6.519 (95% IC 1.9-22.2), p = 0.003].</p><p><strong>Conclusions: </strong>PSAr could be a reliable prognostic factor for long-term biochemical control. This study underscores the potential of PSAr as a tool for risk stratification and personalized follow-up strategies in PCa management.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":"3701-3706"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"PSA reduction as predictor of biochemical relapse in low and favourable intermediate prostate cancer treated with radical radiotherapy.\",\"authors\":\"Andrea Gaetano Allegra, Luca Nicosia, Alessandro Molinari, Chiara De-Colle, Christian Fierro, Niccolò Giaj-Levra, Francesca Giannetti, Claudia Menichelli, Carolina Orsatti, Gabriella Pastore, Edoardo Pastorello, Francesco Ricchetti, Michele Rigo, Andrea Romei, Paola Zuccoli, Alessandro Fanelli, Filippo Alongi\",\"doi\":\"10.1007/s12094-025-03884-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Radiation therapy (RT) is standard treatment for localized prostate cancer (PCa). Prostate-specific antigen (PSA) kinetics, particularly PSA reduction (PSAr) after RT, are emerging as significant prognostic indicators for biochemical control. This retrospective multi-institutional study explores the correlation between PSAr and biochemical relapse-free survival (BRFS). This retrospective multi-institutional study explores the correlation between PSAr and biochemical relapse-free survival (BRFS).</p><p><strong>Methods: </strong>251 low-to-intermediate risk PCa patients treated with RT only were analyzed. Isoeffective RT schedules were: 39 fractions × 2 Gy, 28 × 2.55 Gy, 16 × 3.5 Gy, 5 × 7 Gy. Main objective was BRFS, defined as the time from PSA nadir (PSAn) to PSAn plus 2 ng/ml. PSAr was defined as the percentage of total PSA reduction from baseline. The optimal PSAr cut-off value was defined as 90%. Patients were stratified by PSAr, baseline PSA, Gleason Score (GS), and RT schedules.</p><p><strong>Results: </strong>GS was 3 + 3 in 120 (48%) patients and 3 + 4 in 131 (52%) patients. After a median follow-up of 36 months (30-48), 2 and 5-year BRFS were 97.3% and 95.2%, respectively, in patients with PSAr ≥ 90% and 89.5%, 61.5% in patients with PSAr < 90% (p = 0.00). In the responder population, median time to PSAr 90% was 24 months and the median time to PSAn was 28.7 months (20-38). At univariate and multivariate analyses, PSAr was the only significant predictor of BRFS [HR 6.519 (95% IC 1.9-22.2), p = 0.003].</p><p><strong>Conclusions: </strong>PSAr could be a reliable prognostic factor for long-term biochemical control. This study underscores the potential of PSAr as a tool for risk stratification and personalized follow-up strategies in PCa management.</p>\",\"PeriodicalId\":50685,\"journal\":{\"name\":\"Clinical & Translational Oncology\",\"volume\":\" \",\"pages\":\"3701-3706\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical & Translational Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12094-025-03884-3\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical & Translational Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12094-025-03884-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
PSA reduction as predictor of biochemical relapse in low and favourable intermediate prostate cancer treated with radical radiotherapy.
Purpose: Radiation therapy (RT) is standard treatment for localized prostate cancer (PCa). Prostate-specific antigen (PSA) kinetics, particularly PSA reduction (PSAr) after RT, are emerging as significant prognostic indicators for biochemical control. This retrospective multi-institutional study explores the correlation between PSAr and biochemical relapse-free survival (BRFS). This retrospective multi-institutional study explores the correlation between PSAr and biochemical relapse-free survival (BRFS).
Methods: 251 low-to-intermediate risk PCa patients treated with RT only were analyzed. Isoeffective RT schedules were: 39 fractions × 2 Gy, 28 × 2.55 Gy, 16 × 3.5 Gy, 5 × 7 Gy. Main objective was BRFS, defined as the time from PSA nadir (PSAn) to PSAn plus 2 ng/ml. PSAr was defined as the percentage of total PSA reduction from baseline. The optimal PSAr cut-off value was defined as 90%. Patients were stratified by PSAr, baseline PSA, Gleason Score (GS), and RT schedules.
Results: GS was 3 + 3 in 120 (48%) patients and 3 + 4 in 131 (52%) patients. After a median follow-up of 36 months (30-48), 2 and 5-year BRFS were 97.3% and 95.2%, respectively, in patients with PSAr ≥ 90% and 89.5%, 61.5% in patients with PSAr < 90% (p = 0.00). In the responder population, median time to PSAr 90% was 24 months and the median time to PSAn was 28.7 months (20-38). At univariate and multivariate analyses, PSAr was the only significant predictor of BRFS [HR 6.519 (95% IC 1.9-22.2), p = 0.003].
Conclusions: PSAr could be a reliable prognostic factor for long-term biochemical control. This study underscores the potential of PSAr as a tool for risk stratification and personalized follow-up strategies in PCa management.
期刊介绍：
Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.
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