Predicting post-external beam radiation therapy PSA relapse of prostate cancer using pretreatment MRI

Michael H. Fuchsjäger, Darko Pucar, Michael J. Zelefsky, Zhigang Zhang, Qianxing Mo, Leah S. Ben-Porat, Amita Shukla-Dave, Liang Wang, Victor E. Reuter, Hedvig Hricak

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: To investigate whether pretreatment endorectal magnetic resonance imaging (MRI) findings can predict biochemical relapse in patients with clinically localized prostate cancer treated with external beam radiation therapy (EBRT). Methods and Materials: Between January 2000 and January 2002, 224 patients (median age, 69 years; age range, 45-82 years) with biopsy-proven prostate cancer underwent endorectal MRI before high-dose (≥81Gy) EBRT. The value of multiple clinical and MRI variables in predicting prostate-specific antigen (PSA) relapse at 5 years was determined by use of univariate and multivariate stepwise Cox regression. Clinical variables included pretreatment PSA, clinical T stage, Gleason score, use of neoadjuvant hormonal therapy, and radiation dose. Magnetic resonance imaging variables, derived from retrospective consensus readings by two radiologists, were used to measure intraprostatic and extraprostatic tumor burden. Results: After a median follow-up of 67 months, PSA relapse developed in 37 patients (16.5%). The significant predictors of PSA relapse on univariate analysis were pretreatment PSA, clinical T stage, and multiple MRI variables, including MRI TN stage score; extracapsular extension (ECE) status; number of sextants involved by ECE, all lesions, or index (dominant) lesion; apical involvement; and diameter and volume of index lesion. Pretreatment PSA and ECE status were the only significant independent predictors on multivariate analysis (p < 0.05 for both). Extracapsular extension status was associated with the highest hazard ratio, 3.04; 5-year PSA relapse rates were 7% for no ECE, 20% for unilateral ECE, and 48% for bilateral ECE. Conclusions: Magnetic resonance imaging findings can be used to predict post-EBRT PSA relapse, with ECE status on MRI and pretreatment PSA being significant independent predictors of this endpoint.

Original languageEnglish (US)
Pages (from-to)743-750
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume78
Issue number3
DOIs
StatePublished - Feb 5 2010

Fingerprint

antigens
Prostate-Specific Antigen
pretreatment
magnetic resonance
radiation therapy
Prostatic Neoplasms
Radiotherapy
cancer
Magnetic Resonance Imaging
Recurrence
lesions
sextants
predictions
dosage
Neoadjuvant Therapy
Neoplasm Grading
Tumor Burden
hazards
Reading
regression analysis

Keywords

  • Biochemical recurrence
  • External beam radiation therapy
  • Extracapsular extension
  • MRI
  • Prostate cancer

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Predicting post-external beam radiation therapy PSA relapse of prostate cancer using pretreatment MRI. / Fuchsjäger, Michael H.; Pucar, Darko; Zelefsky, Michael J.; Zhang, Zhigang; Mo, Qianxing; Ben-Porat, Leah S.; Shukla-Dave, Amita; Wang, Liang; Reuter, Victor E.; Hricak, Hedvig.

In: International Journal of Radiation Oncology Biology Physics, Vol. 78, No. 3, 05.02.2010, p. 743-750.

Research output: Contribution to journalArticle

Fuchsjäger, MH, Pucar, D, Zelefsky, MJ, Zhang, Z, Mo, Q, Ben-Porat, LS, Shukla-Dave, A, Wang, L, Reuter, VE & Hricak, H 2010, 'Predicting post-external beam radiation therapy PSA relapse of prostate cancer using pretreatment MRI', International Journal of Radiation Oncology Biology Physics, vol. 78, no. 3, pp. 743-750. https://doi.org/10.1016/j.ijrobp.2009.08.040
Fuchsjäger, Michael H. ; Pucar, Darko ; Zelefsky, Michael J. ; Zhang, Zhigang ; Mo, Qianxing ; Ben-Porat, Leah S. ; Shukla-Dave, Amita ; Wang, Liang ; Reuter, Victor E. ; Hricak, Hedvig. / Predicting post-external beam radiation therapy PSA relapse of prostate cancer using pretreatment MRI. In: International Journal of Radiation Oncology Biology Physics. 2010 ; Vol. 78, No. 3. pp. 743-750.
@article{ac721951eb434145b30eee6e4b863d82,
title = "Predicting post-external beam radiation therapy PSA relapse of prostate cancer using pretreatment MRI",
abstract = "Purpose: To investigate whether pretreatment endorectal magnetic resonance imaging (MRI) findings can predict biochemical relapse in patients with clinically localized prostate cancer treated with external beam radiation therapy (EBRT). Methods and Materials: Between January 2000 and January 2002, 224 patients (median age, 69 years; age range, 45-82 years) with biopsy-proven prostate cancer underwent endorectal MRI before high-dose (≥81Gy) EBRT. The value of multiple clinical and MRI variables in predicting prostate-specific antigen (PSA) relapse at 5 years was determined by use of univariate and multivariate stepwise Cox regression. Clinical variables included pretreatment PSA, clinical T stage, Gleason score, use of neoadjuvant hormonal therapy, and radiation dose. Magnetic resonance imaging variables, derived from retrospective consensus readings by two radiologists, were used to measure intraprostatic and extraprostatic tumor burden. Results: After a median follow-up of 67 months, PSA relapse developed in 37 patients (16.5{\%}). The significant predictors of PSA relapse on univariate analysis were pretreatment PSA, clinical T stage, and multiple MRI variables, including MRI TN stage score; extracapsular extension (ECE) status; number of sextants involved by ECE, all lesions, or index (dominant) lesion; apical involvement; and diameter and volume of index lesion. Pretreatment PSA and ECE status were the only significant independent predictors on multivariate analysis (p < 0.05 for both). Extracapsular extension status was associated with the highest hazard ratio, 3.04; 5-year PSA relapse rates were 7{\%} for no ECE, 20{\%} for unilateral ECE, and 48{\%} for bilateral ECE. Conclusions: Magnetic resonance imaging findings can be used to predict post-EBRT PSA relapse, with ECE status on MRI and pretreatment PSA being significant independent predictors of this endpoint.",
keywords = "Biochemical recurrence, External beam radiation therapy, Extracapsular extension, MRI, Prostate cancer",
author = "Fuchsj{\"a}ger, {Michael H.} and Darko Pucar and Zelefsky, {Michael J.} and Zhigang Zhang and Qianxing Mo and Ben-Porat, {Leah S.} and Amita Shukla-Dave and Liang Wang and Reuter, {Victor E.} and Hedvig Hricak",
year = "2010",
month = "2",
day = "5",
doi = "10.1016/j.ijrobp.2009.08.040",
language = "English (US)",
volume = "78",
pages = "743--750",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Predicting post-external beam radiation therapy PSA relapse of prostate cancer using pretreatment MRI

AU - Fuchsjäger, Michael H.

AU - Pucar, Darko

AU - Zelefsky, Michael J.

AU - Zhang, Zhigang

AU - Mo, Qianxing

AU - Ben-Porat, Leah S.

AU - Shukla-Dave, Amita

AU - Wang, Liang

AU - Reuter, Victor E.

AU - Hricak, Hedvig

PY - 2010/2/5

Y1 - 2010/2/5

N2 - Purpose: To investigate whether pretreatment endorectal magnetic resonance imaging (MRI) findings can predict biochemical relapse in patients with clinically localized prostate cancer treated with external beam radiation therapy (EBRT). Methods and Materials: Between January 2000 and January 2002, 224 patients (median age, 69 years; age range, 45-82 years) with biopsy-proven prostate cancer underwent endorectal MRI before high-dose (≥81Gy) EBRT. The value of multiple clinical and MRI variables in predicting prostate-specific antigen (PSA) relapse at 5 years was determined by use of univariate and multivariate stepwise Cox regression. Clinical variables included pretreatment PSA, clinical T stage, Gleason score, use of neoadjuvant hormonal therapy, and radiation dose. Magnetic resonance imaging variables, derived from retrospective consensus readings by two radiologists, were used to measure intraprostatic and extraprostatic tumor burden. Results: After a median follow-up of 67 months, PSA relapse developed in 37 patients (16.5%). The significant predictors of PSA relapse on univariate analysis were pretreatment PSA, clinical T stage, and multiple MRI variables, including MRI TN stage score; extracapsular extension (ECE) status; number of sextants involved by ECE, all lesions, or index (dominant) lesion; apical involvement; and diameter and volume of index lesion. Pretreatment PSA and ECE status were the only significant independent predictors on multivariate analysis (p < 0.05 for both). Extracapsular extension status was associated with the highest hazard ratio, 3.04; 5-year PSA relapse rates were 7% for no ECE, 20% for unilateral ECE, and 48% for bilateral ECE. Conclusions: Magnetic resonance imaging findings can be used to predict post-EBRT PSA relapse, with ECE status on MRI and pretreatment PSA being significant independent predictors of this endpoint.

AB - Purpose: To investigate whether pretreatment endorectal magnetic resonance imaging (MRI) findings can predict biochemical relapse in patients with clinically localized prostate cancer treated with external beam radiation therapy (EBRT). Methods and Materials: Between January 2000 and January 2002, 224 patients (median age, 69 years; age range, 45-82 years) with biopsy-proven prostate cancer underwent endorectal MRI before high-dose (≥81Gy) EBRT. The value of multiple clinical and MRI variables in predicting prostate-specific antigen (PSA) relapse at 5 years was determined by use of univariate and multivariate stepwise Cox regression. Clinical variables included pretreatment PSA, clinical T stage, Gleason score, use of neoadjuvant hormonal therapy, and radiation dose. Magnetic resonance imaging variables, derived from retrospective consensus readings by two radiologists, were used to measure intraprostatic and extraprostatic tumor burden. Results: After a median follow-up of 67 months, PSA relapse developed in 37 patients (16.5%). The significant predictors of PSA relapse on univariate analysis were pretreatment PSA, clinical T stage, and multiple MRI variables, including MRI TN stage score; extracapsular extension (ECE) status; number of sextants involved by ECE, all lesions, or index (dominant) lesion; apical involvement; and diameter and volume of index lesion. Pretreatment PSA and ECE status were the only significant independent predictors on multivariate analysis (p < 0.05 for both). Extracapsular extension status was associated with the highest hazard ratio, 3.04; 5-year PSA relapse rates were 7% for no ECE, 20% for unilateral ECE, and 48% for bilateral ECE. Conclusions: Magnetic resonance imaging findings can be used to predict post-EBRT PSA relapse, with ECE status on MRI and pretreatment PSA being significant independent predictors of this endpoint.

KW - Biochemical recurrence

KW - External beam radiation therapy

KW - Extracapsular extension

KW - MRI

KW - Prostate cancer

UR - http://www.scopus.com/inward/record.url?scp=77957200095&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957200095&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2009.08.040

DO - 10.1016/j.ijrobp.2009.08.040

M3 - Article

C2 - 20133067

AN - SCOPUS:77957200095

VL - 78

SP - 743

EP - 750

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 3

ER -