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Solomonidou, N.* ; Germanou, D.* ; Strouthos, I.* ; Karagiannis, E.* ; Farolfi, A.* ; Koerber, S.A.* ; Debus, J.* ; Peeken, J.C. ; Vogel, M.M. ; Vrachimis, A.* ; Spohn, S.K.B.* ; Shelan, M.* ; Aebersold, D.* ; Grosu, A.L.* ; Ceci, F.* ; Kroeze, S.G.C.* ; Guckenberger, M.* ; Fanti, S.* ; Belka, C.* ; Hruby, G.* ; Scharl, S.* ; Wiegel, T.* ; Bartenstein, P.* ; Henkenberens, C.* ; Emmett, L.* ; Schmidt-Hegemann, N.S.* ; Ferentinos, K.* ; Zamboglou, C.*

PSMA-PET/CT-guided salvage radiotherapy in recurrent or persistent prostate cancer and PSA < 0.2 ng/ml.

Eur. J. Nucl. Med. Mol. Imaging 50, 2529-2536 (2023)
Verlagsversion DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
PURPOSE: The purpose of this retrospective, multicenter study was to assess efficacy of PSMA-PET/CT-guided salvage radiotherapy (sRT) in patients with recurrent or persistent PSA after primary surgery and PSA levels < 0.2 ng/ml. METHODS: The study included patients from a pooled cohort (n = 1223) of 11 centers from 6 countries. Patients with PSA levels > 0.2 ng/ml prior to sRT or without sRT to the prostatic fossa were excluded. The primary study endpoint was biochemical recurrence-free survival (BRFS) and BR was defined as PSA nadir after sRT + 0.2 ng/ml. Cox regression analysis was performed to assess the impact of clinical parameters on BRFS. Recurrence patterns after sRT were analyzed. RESULTS: The final cohort consisted of 273 patients; 78/273 (28.6%) and 48/273 (17.6%) patients had local or nodal recurrence on PET/CT. The most frequently applied sRT dose to the prostatic fossa was 66-70 Gy (n = 143/273, 52.4%). SRT to pelvic lymphatics was delivered in 87/273 (31.9%) patients and androgen deprivation therapy was given to 36/273 (13.2%) patients. After a median follow-up time of 31.1 months (IQR: 20-44), 60/273 (22%) patients had biochemical recurrence. The 2- and 3-year BRFS was 90.1% and 79.2%, respectively. The presence of seminal vesicle invasion in surgery (p = 0.019) and local recurrences in PET/CT (p = 0.039) had a significant impact on BR in multivariate analysis. In 16 patients, information on recurrence patterns on PSMA-PET/CT after sRT was available and one had recurrent disease inside the RT field. CONCLUSION: This multicenter analysis suggests that implementation of PSMA-PET/CT imaging for sRT guidance might be of benefit for patients with very low PSA levels after surgery due to promising BRFS rates and a low number of relapses within the sRT field.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Psma-pet ; Prostate Cancer ; Prostate-specific Antigen ; Salvage Radiotherapy; Radical Prostatectomy
ISSN (print) / ISBN 1619-7070
e-ISSN 1432-105X
Zeitschrift European Journal of Nuclear Medicine and Molecular Imaging
Quellenangaben Band: 50, Heft: 8, Seiten: 2529-2536 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 Projekt DEAL