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Purpose/Objective:
The ASTRO definition was primarily developed to assess biochemical failure following external beam irradiation (EBRT). The Phoenix (PHNX) definition was found to be a more sensitive and specific definition and takes into account patients treated with the addition of hormonal therapy or those treated with prostate brachytherapy. A recent American Urological Association consensus paper defined a biochemical failure following radical prostatectomy as a PSA > 0.2ng/ml (AUA definition). Trimodality therapy combines hormonal therapy, external beam and brachytherapy. Data following this therapy has not been analyzed in any of the above consensus reports. It is associated with the highest biologically effective dose (BED) and so will be more ablative and perhaps better judged by the AUA definition. Since it uses both EBRT as well as brachytherapy, either of the radiation failure definitions might best be used. Biochemical failures rates were calculated using all three definitions and compared to determine which might be best applied to calculating PSA failure following this form of therapy.
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