The role of PSA in the radiotherapy of prostate cancer

Oncology (Williston Park). 1996 Aug;10(8):1143-53; discussion 1154-61.


Pretreatment prostate-specific antigen (PSA) level is the single most important prognostic factor for patients undergoing radiotherapy for clinically localized prostate cancer. When combined with Gleason score and T-stage, pretreatment PSA enhances our ability to accurately predict pathologic stage. Patients with pretreatment PSA levels > 10 ng/mL are at high risk for biochemical failure when treated with conventional radiation alone. A PSA nadir of > 1 ng/mL and a post-treatment PSA > 1.5 ng/mL are associated with a high risk of biochemical failure. Postoperative radiotherapy delivered while the tumor burden is low (eg, PSA < 1 ng/mL) predicts a favorable outcome. Many of these conclusions about the usefulness of pretreatment PSA are based on the assumption that PSA can be used as a surrogate end point for disease-free and overall survival from prostate cancer. However, this assumption still remains to be validated by phase III trials.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Hormonal / pharmacology
  • Disease-Free Survival
  • Forecasting
  • Humans
  • Male
  • Neoplasm Staging / methods
  • Polymerase Chain Reaction
  • Prognosis
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / radiotherapy*
  • Treatment Outcome


  • Antineoplastic Agents, Hormonal
  • Prostate-Specific Antigen