Prognostic role of serum prostatic acid phosphatase for 103Pd-based radiation for prostatic carcinoma.

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.

• 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)

Chemical References

• Neoplasm Proteins
• Radioisotopes
• Palladium
• Acid Phosphatase
• Prostate-Specific Antigen

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