Posted 3/22/2016 1:15 PM (GMT 0)
Hi JNF,
Yea, this worries me, of course. But I'll paste this abstract below that is giving me some comfort. I know tons of people have weathered through bounces. Send good vibes, please.
Yours,
Mary
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N. M. Mehta, M. Kamrava, P. Wang, P. Kupelian, C. R. King, M. Steinberg, J. Demanes, University of California - Los Angeles, Los Angeles, CA
Purpose/Objective(s): Prostate-specific antigen (PSA) bounce occurs after radiotherapy; however, descriptions of PSA bounce after high dose rate (HDR) monotherapy are few. The purpose of this study was to characterize the magnitude and kinetics of PSA bounce and its clinical significance.
Materials/Methods: Longitudinal PSA data and clinical parameters were examined in 157 consecutive patients treated with HDR monotherapy (7-7.25 Gy x 6) between 1996 and 2005. PSA bounce was defined as a rise in PSA of 0.2 ng/mL or higher with a subsequent PSA returning to the prior level or lower. In order to eliminate statistical aberrations, PSAs recorded as <0.1 were noted as 0.1 ng/mL. PSA failure was defined per the Phoenix definition (nadir + 2). The General Estimate Equation (GEE) model was adopted to examine the longitudinal association between PSA bounce and clinical factors. We mutually adjusted for time to each PSA bounce in our final model.
Results: The median follow-up time was 4.6 years and the median number of post-HDR PSAs was 11. A PSA bounce was noted in 67 patients (43%) with the magnitudes ranging from 0.2 to 9.5. The frequencies of the relative magnitudes of PSA bounce are described in Table 1. The number of bounces per patient was 1 in 45 cases (67%), 2 in 19 (28%), 3 in 2 (3%), 4 in 0 (0%), and 5 in 1 (1%). The
median time to maximum PSA bounce was 1.3 years, its median magnitude was 0.7 and its median duration was 9 months. The median time to PSA nadir was 3.2 years. Three patients (2%) were noted to have PSA failure. The multivariate model revealed that patients < 55 years of age were more likely to experience a bounce (odds ratio (OR) 2.22, p = 0.001). Lower Gleason score also increased the likelihood of experiencing a bounce (OR 1.52, p = 0.045). T stage was not associated with PSA bounce and neither was neoadjuvant androgen deprivation given to 15 patients (9.6%).
Conclusions: PSA bounce after prostate HDR monotherapy occurred frequently and mostly within the first year with a magnitude of ≥1 in 15% of cases. Young age and lower Gleason score correlated with bounce. This information can be used to counsel patients about PSA results and guide subsequent management.