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Open Access Research

Normalization of prostate specific antigen in patients treated with intensity modulated radiotherapy for clinically localized prostate cancer

Matthew D Schmitz1, Gilbert DA Padula23, Patrick Y Chun1 and Alan T Davis45*

  • * Corresponding author: Alan T Davis davisa@msu.edu

  • † Equal contributors

Author Affiliations

1 College of Human Medicine, Michigan State University, East Lansing, MI, USA

2 Department of Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan, USA

3 Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, Michigan, USA

4 Department of Surgery, Michigan State University, Grand Rapids, MI, USA

5 Department of Research, Grand Rapids Medical Education Partners, Grand Rapids, MI, USA

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Radiation Oncology 2010, 5:80  doi:10.1186/1748-717X-5-80

Published: 16 September 2010

Abstract

Background

The purpose of this study was to determine the expected time to prostate specific antigen (PSA) normalization with or without neoadjuvant androgen deprivation (NAAD) therapy after treatment with intensity modulated radiotherapy (IMRT) for patients with clinically localized prostate cancer.

Methods

A retrospective cohort research design was used. A total of 133 patients with clinical stage T1c to T3b prostate cancer (2002 AJCC staging) treated in a community setting between January 2002 and July 2005 were reviewed for time to PSA normalization using 1 ng/mL and 2 ng/mL as criteria. All patients received IMRT as part of their management. Times to PSA normalization were calculated using the Kaplan-Meier method. Significance was assessed at p < 0.05.

Results

Fifty-six of the 133 patients received NAAD (42.1%). Thirty-one patients (23.8%) received radiation to a limited pelvic field followed by an IMRT boost, while 99 patients received IMRT alone (76.2%). The times to serum PSA normalization < 2 ng/mL when treated with or without NAAD were 298 ± 24 and 302 ± 33 days (mean ± SEM), respectively (p > 0.05), and 303 ± 24 and 405 ± 46 days, respectively, for PSA < 1 ng/mL (p < 0.05). Stage T1 and T2 tumors had significantly increased time to PSA normalization < 1 ng/mL in comparison to Stage T3 tumors. Also, higher Gleason scores were significantly correlated with a faster time to PSA normalization < 1 ng/mL.

Conclusions

Use of NAAD in conjunction with IMRT leads to a significantly shortened time to normalization of serum PSA < 1 ng/mL in patients with clinically localized prostate cancer.