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No. 159. Prostate-Specific A ntigen (PSA) rate of decline p ost E xternal B eam Radiotherapy (EBRT) may p redict p rostate c ancer d eath ).

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  1. No. 159 Prostate-Specific Antigen (PSA) rate of decline post External Beam Radiotherapy (EBRT) may predict prostate cancer death) Shi, Zumin 1, Pinnock, Carole 23 4, Kinsey-Trotman, Stephen 5, Borg, Martin 2 6, Moretti, Kim 1 2 5, Walsh, Scott 2 4, Kopsaftis, Tina 2 4 1. University of Adelaide, 2. South Australian (SA) Prostate Cancer Clinical Outcomes Collaborative, 3. Flinders University of South Australia, 4. Repatriation General Hospital, 5. The Queen Elizabeth Hospital, 6. Royal Adelaide Hospital Posters Proudly Supported by: At Introduction A number of studies have demonstrated the prognostic value of prostate-specific antigen (PSA) kinetics post radiotherapy in localised prostate cancer. 1,2 PSA kinetics post radiotherapy have demonstrated unpredictability. 3,4 ASTRO/Phoenix criteria currently defines biochemical failure. 5 Early prognostic information derived from PSA kinetics would be a clear advantage to optimising adjuvant treatments and follow-up strategies post radiotherapy. Results Aim To determine the association between PSA velocity (PSAV) and risk of all-cause mortality and disease-specific mortality within the first two years following external beam radiotherapy (EBRT) for localised prostate cancer. Baseline clinical characteristics by quartiles of PSA velocity (PSAV). Age difference between quartiles not statistically significant (not shown) • Methods Prospectively-maintained database on all prostate cancer patients diagnosed and treated at three metropolitan hospitals in Adelaide. Ethics approval. Literature Review. Database review – Patients treated with EBRT between 1995-2010. • Patients with at least two PSA values post treatment • Cohort of 848 patients satisfied selection criteria PSAV determined for each patient. Cohort divided into quartiles based on PSAV. Third quartile used as a reference group (PSAV approximating zero). Association between PSAV and risk of all-cause mortality and prostate-cancer specific mortality (PCSM) using Cox proportional hazards models. Chi-squared test used to compare differences in categorical variables, ANOVA for continuous variables. Models adjusted for age, Gleason score, PSA at diagnosis and ADT. Proportion of patient deaths (all-cause) by PSAV quartile Plot of PSA velocities for individual patients in reference group (Q3) U-Shaped Association (Hazards Ratio 95% CI) between PSAV level and prostate cancer specific mortality (patients who died within two years of EBRT excluded) Conclusions PSAV was demonstrated to be an independent prognostic indicator in predicting death from prostate cancer. Patients in the lowest and highest quartiles of PSAV were associated with prostate cancer death. References 1. Chauvet et al, 1994, ‘Prostate-Specific Antigen Decline: A Major Prognostic Factor for Prostate Cancer Treated with Radiation Therapy’, JCO, vol.12, no.7, pp.1402-7. 2. D’Amico, AV & Hanks, GE, 1993, ‘Linear Regressive Analysis Prostate-Specific Antigen Doubling Time for Predicting Tumour Biology and Clinical Outcome in Prostate Cancer’, Cancer, vol.72, pp.2638-43. 3. Kaplan et al, 1991, ‘A Model of Prostatic Carcinoma Tumour Kinetics Based on Prostate Specific Antigen Levels After Radiation Therapy’, Cancer, vol.68, pp.400-405. 4. Vollmer, RT & Montana, GS, 1999, ‘The Dynamics of Prostate-Specific Antigen after Definitive Radiation Therapy for Prostate Cancer’, Clin.Can.Res. Vol.5, pp.4119-25. 5. Roach, M et al, 2006, ‘Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localised prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference.’ Int.J.Rad.Oncol.Bio.Phys. Vol65. no.4., pp.965-74. Acknowledgements Support staff for the South Australian (SA) Prostate Cancer Clinical Outcomes Collaborative.

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