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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)
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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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Psma-pet ; Personalization ; Risk Stratification ; Suvmax ; Salvage Radiotherapy; Ga-68-psma Pet/ct; Adjuvant Radiotherapy; Radiation-therapy; Validation; Phase-3
Language
english
Publication Year
2022
HGF-reported in Year
2022
ISSN (print) / ISBN
1619-7070
e-ISSN
1432-105X
Quellenangaben
Volume: 50,
Issue: 1,
Pages: 218-227
Publisher
Springer
Publishing Place
One New York Plaza, Suite 4600, New York, Ny, United States
Reviewing status
Peer reviewed
Institute(s)
Institute of Radiation Medicine (IRM)
POF-Topic(s)
30203 - Molecular Targets and Therapies
Research field(s)
Radiation Sciences
PSP Element(s)
G-501300-001
Grants
DKTK
WOS ID
000842719300001
WOS ID
WOS:000842719300001
Scopus ID
85136529163
PubMed ID
35984452
Erfassungsdatum
2022-11-16