Monitoring of total and free prostate-specific antigen, neuroendocrine markers and testosterone in patients with localised-prostate cancer treated by brachytherapy or conformal radiotherapy

Localised prostate-cancer patients treated by brachytherapy (CT, n= 57) or conformal external beam radiotherapy (RTE, n=47) were followed before, during and after radiotherapy, with serial assays of total PSA (tPSA), free PSA (fPSA), chromogranin A (CgA), neuron-specific enolase (NSE) and testosterone. During follow-up (median: 5.3 years), five biological. failures, 10 local recurrences and five metastases were recorded. Overall, tPSA and fPSA concentrations were correlated (n=740), together with nadir tPSA and fPSA concentrations and times to nadir (n=104), all with p<0.0001. In patients without neoadjuvant-hormone therapy (n=75), tPSA half-life was 97 days (range: eight to 360 days) for CT patients and 113 days (range: 29 to 358 days) for RTE patients (nonsignificant difference). Neoadjuvant treatment resulted in a shortened tPSA half-life and a lower tPSA nadir reached in a shorter time. Serum CgA was more elevated in Gleason >= 6 tumours than in the opposite group (p=0.012). (C) 2008 Elsevier Masson SAS. Tous droits reserves.