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(Radiology. 2000;215:757-760.)
© RSNA, 2000

Radiation Oncology

Prostate-Specific Antigen: Effect of Pelvic Irradiation1

Stephan Gripp, MD, J. Christoph Haller, MD, Jürgen Metz and Reinhardt Willers, PhD

1 From the Departments of Radiation Oncology (S.G., J.C.H., J.M.) and Biostatistics (R.W.), Klinik für Strahlentherapie und Radiogische Onkologie, Heinrich-Heine-Universität Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany. Received October 4, 1999; revision requested October 20; revision received December 3; accepted December 17. Address correspondence to S.G. (e-mail: stephan.gripp@uni-duesseldorf.de).

PURPOSE: To study the effect of pelvic irradiation on the level of serum prostate-specific antigen (PSA).

MATERIALS AND METHODS: Of 33 patients treated with pelvic irradiation to the prostate and seminal vesicles for anal and rectal cancer, 26 received 50.4 Gy or more (1.8 Gy per fraction), and seven received 25.0 Gy (5.0 Gy per fraction). PSA levels were measured before (n = 33), during (n = 26), and after radiation therapy (n = 33). In 24 patients, follow-up (mean, 15.7 months) PSA data were obtained. Actual and pretreatment PSA levels were compared (Wilcoxon rank test).

RESULTS: During the first 3 weeks in all patients, PSA levels rose steeply, culminating in a 3.7-fold increase (P = .02). At the end of radiation therapy (7 weeks), the PSA level was no longer significantly different from the pretreatment value. In the long term, the PSA level decreased to 77% of the pretreatment value (P = .04).

CONCLUSION: Irradiation of the prostate initially elevates serum PSA levels. Apparently PSA release is determined by the duration of radiation therapy, while the accumulated dose has a minor effect. In the long term, PSA production is impaired after radical radiation therapy. PSA reference concentrations should be adjusted to these reduced levels.

Index terms: Anus, therapeutic radiology, 757.1299 • Prostate, 844.1299 • Prostate neoplasms, therapeutic radiology, 844.1299 • Radiations, injurious effects, 844.1269, 844.458 • Rectum, therapeutic radiology, 757.1299




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