![]() ![]() This analysis describes early observations of the incidence of transient PSA elevation following external beam and HDR brachytherapy for prostate cancer. However, there is limited data on this phenomena following HDR brachytherapy. Such transient elevations, or benign 'PSA bounces', after EBRT and/or LDR brachytherapy have been described. Regardless of the definition, elevations in the PSA that rise and subsequently fall without treatment make it difficult to distinguish an actual failure from a transient and self-limited elevation. After failure, patients may consider salvage therapy, including additional local therapies or hormone therapy. Though no definition is definitively superior, the ASTRO definition of failure (3 consecutive rises in PSA over the last 9 months) has been used in many large prostate cancer trials. ![]() Given this variability, different definitions of failure have been suggested. Independent of treatment, there is some natural variation in PSA levels. If RT fails, the PSA increases over time. When RT is successful, the PSA level falls. Prostate-specific antigen (PSA) is a sensitive measure of treatment outcome after radiotherapy (RT) for prostate cancer. Low dose rate (LDR) brachytherapy, with permanently implanted radioactive seeds, and HDR brachytherapy, with temporarily implanted catheters, has been used to treat prostate cancer. External beam radiation therapy (EBRT) and/or brachytherapy are mainstays of local therapy. There are over 200,000 new cases and nearly 30,000 deaths each year from prostate cancer.
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