Abstract | PURPOSE: To establish the prognostic role of serum enzymatic prostatic acid phosphatase (PAP) in patients treated with palladium (103Pd) and supplemental external beam irradiation (EBRT) for clinically localized, high-risk prostate carcinoma. METHODS AND MATERIALS: One hundred twenty-four consecutive patients with Stage T2a-T3 prostatic carcinoma were treated from 1992 through 1995. Each patient had at least one of the following risk factors for extracapsular disease extension: Stage T2b or greater (100 patients), Gleason score 7-10 (40 patients), pretreatment prostate specific antigen (PSA) >15 ng/ml (32 patients), or elevated serum PAP (25 patients). Patients received 41 Gy conformal EBRT to a limited pelvic field, followed 4 weeks later by a 103Pd boost (prescription dose 80 Gy). Biochemical failure was defined as a PSA greater than 1 ng/ml (normal <4 ng/ml). RESULTS: The overall, actuarial freedom from biochemical failure at 4 years after treatment was 79%. In Cox-proportional hazard multivariate analysis, the strongest predictor of failure was elevated pretreatment acid phosphatase (p = 0.02), followed by Gleason score (p = 0.1), and PSA (p = 0.14). CONCLUSION: PAP was the strongest predictor of long-term biochemical failure. It may be a more accurate indicator of micrometastatic disease than PSA, and as such, we suggest that it be reconsidered for general use in radiation-treated patients.
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Authors | M Dattoli, K Wallner, L True, R Sorace, J Koval, J Cash, R Acosta, M Biswas, M Binder, B Sullivan, E Lastarria, N Kirwan, D Stein |
Journal | International journal of radiation oncology, biology, physics
(Int J Radiat Oncol Biol Phys)
Vol. 45
Issue 4
Pg. 853-6
(Nov 01 1999)
ISSN: 0360-3016 [Print] United States |
PMID | 10571189
(Publication Type: Journal Article)
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Chemical References |
- Neoplasm Proteins
- Radioisotopes
- Palladium
- Acid Phosphatase
- Prostate-Specific Antigen
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Topics |
- Acid Phosphatase
(blood)
- Aged
- Aged, 80 and over
- Brachytherapy
- Humans
- Male
- Middle Aged
- Multivariate Analysis
- Neoplasm Proteins
(blood)
- Neoplasm Staging
- Palladium
(therapeutic use)
- Prognosis
- Prostate-Specific Antigen
(blood)
- Prostatic Neoplasms
(blood, pathology, radiotherapy)
- Radioisotopes
(therapeutic use)
- Treatment Failure
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