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Spohn, S.K.B.* ; Farolfi, A.* ; Schandeler, S.* ; Vogel, M.M.E.* ; Ruf, J.* ; Mix, M.* ; Kirste, S.* ; Ceci, F.* ; Fanti, S.* ; Lanzafame, H.* ; Serani, F.* ; Gratzke, C.* ; Sigle, A.* ; Combs, S.E. ; Bernhardt, D.* ; Gschwend, J.E.* ; Buchner, J.A.* ; Trapp, C.* ; Belka, C.* ; Bartenstein, P.* ; Unterrainer, L.* ; Unterrainer, M.* ; Eiber, M.* ; Nekolla, S.G.* ; Schiller, K.* ; Grosu, A.L.* ; Schmidt-Hegemann, N.S.* ; Zamboglou, C.* ; Peeken, J.C.

The maximum standardized uptake value in patients with recurrent or persistent prostate cancer after radical prostatectomy and PSMA-PET-guided salvage radiotherapy-a multicenter retrospective analysis.

Eur. J. Nucl. Med. Mol. Imaging 50, 218-227 (2022)
Verlagsversion Forschungsdaten DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
PURPOSE: This study aims to evaluate the association of the maximum standardized uptake value (SUVmax) in positron-emission tomography targeting prostate-specific membrane antigen (PSMA-PET) prior to salvage radiotherapy (sRT) on biochemical recurrence free survival (BRFS) in a large multicenter cohort. METHODS: Patients who underwent 68 Ga-PSMA11-PET prior to sRT were enrolled in four high-volume centers in this retrospective multicenter study. Only patients with PET-positive local recurrence (LR) and/or nodal recurrence (NR) within the pelvis were included. Patients were treated with intensity-modulated-sRT to the prostatic fossa and elective lymphatics in case of nodal disease. Dose escalation was delivered to PET-positive LR and NR. Androgen deprivation therapy was administered at the discretion of the treating physician. LR and NR were manually delineated and SUVmax was extracted for LR and NR. Cox-regression was performed to analyze the impact of clinical parameters and the SUVmax-derived values on BRFS. RESULTS: Two hundred thirty-five patients with a median follow-up (FU) of 24 months were included in the final cohort. Two-year and 4-year BRFS for all patients were 68% and 56%. The presence of LR was associated with favorable BRFS (p = 0.016). Presence of NR was associated with unfavorable BRFS (p = 0.007). While there was a trend for SUVmax values ≥ median (p = 0.071), SUVmax values ≥ 75% quartile in LR were significantly associated with unfavorable BRFS (p = 0.022, HR: 2.1, 95%CI 1.1-4.6). SUVmax value in NR was not significantly associated with BRFS. SUVmax in LR stayed significant in multivariate analysis (p = 0.030). Sensitivity analysis with patients for who had a FU of > 12 months (n = 197) confirmed these results. CONCLUSION: The non-invasive biomarker SUVmax can prognosticate outcome in patients undergoing sRT and recurrence confined to the prostatic fossa in PSMA-PET. Its addition might contribute to improve risk stratification of patients with recurrent PCa and to guide personalized treatment decisions in terms of treatment intensification or de-intensification. This article is part of the Topical Collection on Oncology-Genitourinary.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Psma-pet ; Personalization ; Risk Stratification ; Suvmax ; Salvage Radiotherapy; Ga-68-psma Pet/ct; Adjuvant Radiotherapy; Radiation-therapy; Validation; Phase-3
ISSN (print) / ISBN 1619-7070
e-ISSN 1432-105X
Zeitschrift European Journal of Nuclear Medicine and Molecular Imaging
Quellenangaben Band: 50, Heft: 1, Seiten: 218-227 Artikelnummer: , Supplement: ,
Verlag Springer
Verlagsort One New York Plaza, Suite 4600, New York, Ny, United States
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Radiation Medicine (IRM)
Förderungen DKTK