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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
Patterns of failure after radical prostatectomy in prostate cancer – implications for radiation therapy planning after 68Ga-PSMA-PET imaging.
Eur. J. Nucl. Med. Mol. Imaging 44, 1656–1662 (2017)
Background: Salvage radiotherapy (SRT) after radical prostatectomy (RPE) and lymphadenectomy (LAE) is the appropriate radiotherapy option for patients with persistent/ recurrent prostate cancer (PC). 68Ga-PSMA-PET imaging has been shown to accurately detect PC lesions in a primary setting as well as for local recurrence or for lymph node (LN) metastases. Objective: In this study we evaluated the patterns of recurrence after RPE in patients with PC, putting a highlight on the differentiation between sites that would have been covered by a standard radiation therapy (RT) field in consensus after the RTOG consensus and others that would have not. Methods and materials: Thirty-one out of 83 patients (37%) with high-risk PC were the subject of our study. Information from 68Ga-PSMA-PET imaging was used to individualize treatment plans to include suspicious lesions as well as possibly boost sites with tracer uptake in LN or the prostate bed. For evaluation, 68Ga-PSMA-PET-positive LN were contoured in a patient dataset with a standard lymph drainage (RTOG consensus on CTV definition of pelvic lymph nodes) radiation field depicting color-coded nodes that would have been infield or outfield of that standard lymph drainage field and thereby visualizing typical patterns of failure of a “blind” radiation therapy after RPE and LAE. Results: Compared to negative conventional imaging (CT/MRI), lesions suspicious for PC were detected in 27/31 cases (87.1%) by 68Ga-PSMA-PET imaging, which resulted in changes to the radiation concept. There were 16/31 patients (51.6%) that received a simultaneous integrated boost (SIB) to a subarea of the prostate bed (in only three cases this dose escalation would have been planned without the additional knowledge of 68Ga-PSMA-PET imaging) and 18/31 (58.1%) to uncommon (namely presacral, paravesical, pararectal, preacetabular and obturatoric) LN sites. Furthermore, 14 patients (45.2%) had a changed TNM staging result by means of 68Ga-PSMA-PET imaging. Conclusion: Compared to conventional CT or MRI staging, 68Ga-PSMA-PET imaging detects more PC lesions and, thus, significantly influences radiation planning in recurrent prostate cancer patients enabling individually tailored treatment.
Impact Factor
Scopus SNIP
Web of Science
Times Cited
Times Cited
Scopus
Cited By
Cited By
Altmetric
7.277
1.898
33
41
Anmerkungen
Besondere Publikation
Auf Hompepage verbergern
Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
68ga-psma-pet Imaging ; Lymphadenectomy ; Prostate Cancer ; Radical Prostatectomy ; Salvage Radiotherapy ; Tailored Treatment; Androgen Suppression; Biochemical Recurrence; Diagnostic-value; Hbed-cc; Radiotherapy; Pet/ct; Deprivation; Irradiation; Monotherapy; Castration
Sprache
englisch
Veröffentlichungsjahr
2017
HGF-Berichtsjahr
2017
ISSN (print) / ISBN
1619-7070
e-ISSN
1432-105X
Quellenangaben
Band: 44,
Heft: 10,
Seiten: 1656–1662
Verlag
Springer
Verlagsort
New York
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Radiation Medicine (IRM)
POF Topic(s)
30203 - Molecular Targets and Therapies
Forschungsfeld(er)
Radiation Sciences
PSP-Element(e)
G-501300-001
PubMed ID
28646463
WOS ID
WOS:000406635300006
Scopus ID
85021235016
Erfassungsdatum
2017-07-24