Caloglu, MuratCiezki, Jay P.Reddy, Chandana A.Angermeier, KennethUlchaker, JamesChehade, NabilAltman, Andrew2024-06-122024-06-1220110360-3016https://doi.org/10.1016/j.ijrobp.2010.02.021https://hdl.handle.net/20.500.14551/19096Purpose: To determine clinical or dosimetric factors associated with a prostate-specific antigen (PSA) bounce, as well as an association between a PSA bounce and biochemical relapse-free survival (bRFS), in patients treated with iodine-125 brachytherapy. Methods and Materials: A variety of clinical and treatment factors were examined in 820 patients who had a minimum of 3 years of PSA follow-up with T1-T2cN0M0 prostate cancer. Four different PSA threshold values were used for defining a PSA bounce: a PSA rise of >= 0.2, >= 0.4, >= 0.6, and >= 0.8 ng/mL. Results: A PSA bounce of >= 0.2, >= 0.4, >= 0.6, and >= 0.8 ng/mL was noted in 247 patients (30.1%), 161 (19.6%), 105 (12.8%), and 78 (9.5%), respectively. The median time to the first PSA rise was 17.4, 16.25, 16.23, and 15.71 months, respectively, vs. 34.35 months for a biochemical failure (p < 0.0001). A PSA rise of >= 0.2 ng/mL was the only definition for which there was a significant difference in bRFS between bounce and non-bounce patients. The 5-year bRFS rate of patients having a PSA bounce of >= 0.2 was 97.7% vs. 91% for those who did not have a PSA bounce (p = 0.0011). On univariate analysis for biochemical failure, age, risk group, and PSAs per year had a statistically significant correlation with PSA bounce of >= 0.2 ng/mL. On multivariate analysis, age and PSAs per year remained statistically significant (p < 0.0001 and p = 0.0456, respectively). Conclusions: A bounce definition of a rise >= 0.2 ng/mL is a reliable definition among several other definitions. The time to first PSA rise is the most valuable factor for distinguishing between a bounce and biochemical failure. (C) 2011 Elsevier Inc.en10.1016/j.ijrobp.2010.02.021info:eu-repo/semantics/closedAccessBiochemical FailureBounceBrachytherapyProstate CancerPSAExternal-Beam RadiationAntigen BounceSeed ImplantationRecommendationsRadiotherapyKineticsTherapyArticle803735741Q1WOS:0002917117000142-s2.0-7995754645420646846Q1