PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level Posts in the discussion thread "PSA cut off level" - Maximum PSA level to omit local treatment Sun, 07 Jun 2026 22:29:28 +0000 http://isocentre.wikidot.com/forum/t-351872#post-1143858 Re: PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level#post-1143858 Wed, 04 May 2011 20:42:50 +0000 Alfonso Gomez 707519 Thank you guys for your posts, it has been very helpful again. I will take a look into the highest PSA level enrolled in PR 07 trial. I have decided to treat this patient with RT escalated doses and livetime ADT.

]]> http://isocentre.wikidot.com/forum/t-351872#post-1142376 Re: PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level#post-1142376 Tue, 03 May 2011 06:40:22 +0000 AAM 61952 TROG was a 'local' trial here. The longer the duration of hormones the better the result has been the outcome of the vast majority of comparisons (starting with one from NZ - http://www.ncbi.nlm.nih.gov/pubmed/8600087). The follow up trial to 96.01 ("RADAR") uses 2 years of adjuvant androgen ablation, so you shouldn't use just 6 months in this man.

]]> http://isocentre.wikidot.com/forum/t-351872#post-1142118 Re: PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level#post-1142118 Mon, 02 May 2011 23:40:06 +0000 Rohit Malde 418807 Another partially related and recently published trial is

Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial

Volume 12, Issue 5, May 2011, Pages 451-459

Conclusion: 6 months of neoadjuvant androgen deprivation combined radiotherapy is an effective treatment option for locally advanced prostate cancer, particularly in men without nodal metastases or pre-existing metabolic comorbidities that could be exacerbated by prolonged androgen deprivation.

This trial showed 6 months better than 3 months ADT

Notes: They allowed pts with PSA = 203.9 ng / ml into the trial…

Someone could look into the PR 07 trial , the highest PSA level enrolled in the study.

]]> http://isocentre.wikidot.com/forum/t-351872#post-1142022 Re: PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level#post-1142022 Mon, 02 May 2011 21:37:19 +0000 Rohit Malde 418807 I believe we have had a discussion in the past regarding this scenario.
And i mentioned about the ambitious STAMPEDE trial looking into this matter.
Its got a complex 6 arm trial. Find details on internet or in the past posts….

Recently i m not sure whether you guys are aware there was the practice changing results of a trial called PR07 trial reported in last years ASCO.

http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=74&abstractID=49170

And giving radiotherapy in addition to hormone therapy improves survival for men with locally advanced prostate cancer.

http://www.ctu.mrc.ac.uk/news_and_press_releases/news_archive/pr07_interim_analysis_010710.aspx

]]> http://isocentre.wikidot.com/forum/t-351872#post-1141249 Re: PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level#post-1141249 Mon, 02 May 2011 04:01:27 +0000 radtuxabhishek 495857 A valid suggestion?

Get his PSA re-checked from a different lab AFTER making sure that there has been no "digital manipulation" of his prostate before we jump to conclusions.

I think it would be a worthwhile trial.

]]> http://isocentre.wikidot.com/forum/t-351872#post-1141235 Re: PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level#post-1141235 Mon, 02 May 2011 03:22:33 +0000 Nikhilesh Patil 416151 I fully agree with Andrew, treat this gentleman with RT and Hormones. Atleast RT will delay local progression and hormones will help control the disease for some time.

]]> http://isocentre.wikidot.com/forum/t-351872#post-1141070 Re: PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level#post-1141070 Sun, 01 May 2011 21:38:37 +0000 AAM 61952 The controversy is whether PSA is part of staging.

If not, then the case is HIGH RISK and should be treated with the intent of cure with neoadjuvant hormones, primary radiotherapy and adjuvant hormones (probably lifetime).

If you think it is, then I'd like to be informed of the system as I haven't seen it published.

Even if you believe his metastatic rate is 100%, the local radiotherapy will mean that local failure is very very unlikely, so local treatment is not wasted. Hormones alone will see local failure in 5-7 years (what I call the "Trial of Death" approach!)

]]> http://isocentre.wikidot.com/forum/t-351872#post-1140801 PSA cut off level http://isocentre.wikidot.com/forum/t-351872/psa-cut-off-level#post-1140801 Sun, 01 May 2011 15:48:22 +0000 Alfonso Gomez 707519 Hi everyone,
I have lastly seen patients with very high PSA levels and negative staging studies. For example, in a young patient with a PSA of 400, Gleason 8, cT3b cN0 and no mets in staging studies. Can you recommend local treatment?? Do you know any references supporting radical treatment in these patients?

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