Pooled analysis of prognostic value of PSA level at 6 months after radiotherapy for localized prostate cancer

Pooled individual patient data from 16 randomized trials evaluated the prognostic impact of PSA a 6 months after completion of radiotherapy (RT) in patients treated with RT with or without androgen deprivation therapy (ADT) for localized prostate cancer between 1987 and 2011. Ninety-eight percent of patients allocated to RT alone, 84% of patients allocated to RT plus short-term ADT (3-6 months), and 77% allocated to RT plus long-term ADT (24-36 months) had PSA ≥ 0.1 ng/ml within 6 months after RT. PSA ≥ 0.1 ng/ml within 6 months was associated with shorter metastasis-free and overall survival and higher prostate cancer-specific mortality. Five-year metastasis-free survival rates among patients allocated to RT, RT plus short-term ADT, and RT plus long-term ADT were 91% versus 79%, 83% versus 76%, and 87% versus 74%, respectively, based on PSA < versus ≥ 0.1 ng/ml. The authors conclude that PSA ≥0.1 ng/ml within 6 months after RT was prognostic for long-term outcomes in patients treated with RT ± ADT for localized prostate cancer.