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Mohammadpour RA, Yazdani-Charati J, Faghani S, et al. Radiation dose-response (a Bayesian model) in the radiotherapy of the localized prostatic adenocarcinoma: the reliability of PSA slope changes as a response surrogate endpoint. PeerJ. 2019;7:e7172doi: 10.7717/peerj.7172.
Mohammadpour, R. A., Yazdani-Charati, J., Faghani, S., Alizadeh, A., & Barzegartahamtan, M. (2019). Radiation dose-response (a Bayesian model) in the radiotherapy of the localized prostatic adenocarcinoma: the reliability of PSA slope changes as a response surrogate endpoint. PeerJ, 7e7172. https://doi.org/10.7717/peerj.7172
Mohammadpour, Reza Ali, et al. "Radiation dose-response (a Bayesian model) in the radiotherapy of the localized prostatic adenocarcinoma: the reliability of PSA slope changes as a response surrogate endpoint." PeerJ vol. 7 (2019): e7172. doi: https://doi.org/10.7717/peerj.7172
Mohammadpour RA, Yazdani-Charati J, Faghani S, Alizadeh A, Barzegartahamtan M. Radiation dose-response (a Bayesian model) in the radiotherapy of the localized prostatic adenocarcinoma: the reliability of PSA slope changes as a response surrogate endpoint. PeerJ. 2019 Jul 01;7:e7172. doi: 10.7717/peerj.7172. eCollection 2019. PMID: 31304057; PMCID: PMC6610535.
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PeerJ. 2019 Jul 01;7:e7172. doi: 10.7717/peerj.7172. eCollection 2019.

Radiation dose-response (a Bayesian model) in the radiotherapy of the localized prostatic adenocarcinoma: the reliability of PSA slope changes as a response surrogate endpoint.

PeerJ

Reza Ali Mohammadpour, Jamshid Yazdani-Charati, SZahra Faghani, Ahad Alizadeh, Mohammadreza Barzegartahamtan

Affiliations

  1. Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
  2. Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
  3. Department of Radiation Oncology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

PMID: 31304057 PMCID: PMC6610535 DOI: 10.7717/peerj.7172

Abstract

PURPOSE: One of the characteristics of Prostate-Specific Antigen (PSA) is PSA slope. It is the rate of diminishing PSA marker over time after radiotherapy (RT) in prostate cancer (PC) patients. The purpose of this study was to evaluate the relationship between increasing RT doses and PSA slope as a potential surrogate for PC recurrence.

PATIENTS AND METHODS: This retrospective study was conducted on PC patients who were treated by radiotherapy in the Cancer Institute of Iran during 2007-2012. By reviewing the records of these patients, the baseline PSA measurement before treatment (iPSA), Gleason score (GS), clinical T stage (T. stage), and periodic PSA measurements after RT and the total radiation dose received were extracted for each patient separately. We used a Bayesian dose-response model, analysis of variance, Kruskal-Wallis test, Kaplan-Meier product-limit method for analysis. Probability values less 0.05 were considered statistically significant.

RESULTS: Based on the D'Amico risk assessment system, 13.34% of patients were classified as "Low Risk", 51.79% were "Intermediate Risk", and 34.87% were "High Risk". In terms of radiation doses, 12.31% of the patients received fewer than 50 Gy, 15.38% received 50 to 69 Gy, 61.03% received 70 Gy, and 11.28% received more than 70 Gy. The PSA values decreased after RT for all dose levels. The slope of PSA changes was negative for 176 of 195 patients. By increasing the dosage of radiation, the PSA decreased but these changes were not statistically significant (

CONCLUSION: Significant changes in the dose-response relationship were not observed when the PSA slope was considered as the response criterion. Therefore, although the absolute value of the PSA decreased with increasing doses of RT, the relationship between PSA slope changes and increasing doses was not clear and cannot be used as a reliable response surrogate endpoint.

Keywords: Bayesian dose-response; Prostate cancer; Prostate-specific antigen slope; Radiotherapy

Conflict of interest statement

The authors declare there are no competing interests.

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