Predicting post-external beam radiation therapy PSA relapse of prostate cancer using pretreatment MRI Journal Article
| Authors: | Fuchsjäger, M. H.; Pucar, D.; Zelefsky, M. J.; Zhang, Z.; Mo, Q.; Ben Porat, L. S.; Shukla-Dave, A.; Wang, L.; Reuter, V. E.; Hricak, H. |
| Article Title: | Predicting post-external beam radiation therapy PSA relapse of prostate cancer using pretreatment MRI |
| Abstract: | Purpose: To investigate whether pretreatment endorectal magnetic resonance imaging (MRI) findings can predict biochemical relapse in patients with clinically localized prostate cancer treated with external beam radiation therapy (EBRT). Methods and Materials: Between January 2000 and January 2002, 224 patients (median age, 69 years; age range, 45-82 years) with biopsy-proven prostate cancer underwent endorectal MRI before high-dose (≥81Gy) EBRT. The value of multiple clinical and MRI variables in predicting prostate-specific antigen (PSA) relapse at 5 years was determined by use of univariate and multivariate stepwise Cox regression. Clinical variables included pretreatment PSA, clinical T stage, Gleason score, use of neoadjuvant hormonal therapy, and radiation dose. Magnetic resonance imaging variables, derived from retrospective consensus readings by two radiologists, were used to measure intraprostatic and extraprostatic tumor burden. Results: After a median follow-up of 67 months, PSA relapse developed in 37 patients (16.5%). The significant predictors of PSA relapse on univariate analysis were pretreatment PSA, clinical T stage, and multiple MRI variables, including MRI TN stage score; extracapsular extension (ECE) status; number of sextants involved by ECE, all lesions, or index (dominant) lesion; apical involvement; and diameter and volume of index lesion. Pretreatment PSA and ECE status were the only significant independent predictors on multivariate analysis (p < 0.05 for both). Extracapsular extension status was associated with the highest hazard ratio, 3.04; 5-year PSA relapse rates were 7% for no ECE, 20% for unilateral ECE, and 48% for bilateral ECE. Conclusions: Magnetic resonance imaging findings can be used to predict post-EBRT PSA relapse, with ECE status on MRI and pretreatment PSA being significant independent predictors of this endpoint. © 2010 Elsevier Inc. All rights reserved. |
| Keywords: | adult; treatment outcome; aged; aged, 80 and over; middle aged; major clinical study; cancer adjuvant therapy; cancer patient; radiation dose; neoadjuvant therapy; cancer staging; nuclear magnetic resonance imaging; follow up; follow-up studies; magnetic resonance imaging; antineoplastic agent; neoplasm staging; prostate specific antigen; neoplasm recurrence, local; tumor volume; proportional hazards models; radiotherapy dosage; radiotherapy; time factors; cancer hormone therapy; prostate cancer; gleason score; prostate-specific antigen; prostatic neoplasms; radiologist; tumor burden; forecasting; cancer relapse; external beam radiotherapy; multivariant analysis; biochemical recurrence; prostate cancers; diseases; mri; resonance; extracapsular extension; external beam radiation therapy |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 78 |
| Issue: | 3 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-11-01 |
| Start Page: | 743 |
| End Page: | 750 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2009.08.040 |
| PUBMED: | 20133067 |
| PROVIDER: | scopus |
| PMCID: | PMC2891893 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: IOBPD" - "Source: Scopus" |
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