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Scharl, S.* ; Zamboglou, C.* ; Strouthos, I.* ; Farolfi, A.* ; Serani, F.* ; Lanzafame, H.* ; Giuseppe Morganti, A.* ; Trapp, C.* ; Koerber, S.A.* ; Debus, J.* ; Peeken, J.C. ; Vogel, M.M. ; Vrachimis, A.* ; Spohn, S.K.B.* ; Ruf, J.* ; Grosu, A.L.* ; Ceci, F.* ; Fendler, W.P.* ; Bartenstein, P.* ; Kroeze, S.G.C.* ; Guckenberger, M.* ; Krafcsik, M.* ; Klopscheck, C.* ; Fanti, S.* ; Hruby, G.* ; Emmett, L.* ; Belka, C.* ; Stief, C.* ; Schmidt-Hegemann, N.S.* ; Henkenberens, C.* ; Mayer, B.* ; Miksch, J.* ; Shelan, M.* ; Aebersold, D.M.* ; Thamm, R.* ; Wiegel, T.*

Salvage radiotherapy is effective in patients with PSMA-PET-negative biochemical recurrence- results of a retrospective study.

Radiother. Oncol. 184:109678 (2023)
DOI PMC
BACKGROUND/PURPOSE: The present study aimed to assess whether SRT to the prostatic fossa should be initiated in a timely manner after detecting biochemical recurrence (BR) in patients with prostate cancer, when no correlate was identified with prostate-specific membrane antigen positron emission tomography (PSMA-PET). MATERIALS AND METHODS: This retrospective, multicenter analysis included 1222 patients referred for PSMA-PET after a radical prostatectomy due to BR. Exclusion criteria were: pathological lymph node metastases, prostate-specific antigen (PSA) persistence, distant or lymph node metastases, nodal irradiation, and androgen deprivation therapy (ADT). This led to a cohort of 341 patients. Biochemical progression-free survival (BPFS) was the primary study endpoint. RESULTS: The median follow-up was 28.0 months. The 3-year BPFS was 71.6% in PET-negative cases and 80.8% in locally PET-positive cases. This difference was significant in univariate (p = 0.019), but not multivariate analyses (p = 0.366, HR: 1.46, 95%CI: 0.64-3.32). The 3-year BPFS in PET-negative cases was significantly influenced by age (p = 0.005), initial pT3/4 (p < 0.001), pathology scores (ISUP) ≥ 3 (p = 0.026), and doses to fossa > 70 Gy (p = 0.027) in univariate analyses. In multivariate analyses, only age (HR: 1.096, 95%CI: 1.023-1.175, p = 0.009) and PSA-doubling time (HR: 0.339, 95%CI: 0.139-0.826, p = 0.017) remained significant. CONCLUSION: To our best knowledge, this study provided the largest SRT analysis in patients without ADT that were lymph node-negative on PSMA-PET. A multivariate analysis showed no significant difference in BPFS between locally PET-positive and PET-negative cases. These results supported the current EAU recommendation to initiate SRT in a timely manner after detecting BR in PET negative patients.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Pet Negative ; Psma Pet-ct ; Prostate Cancer ; Salvage Radiotherapy
ISSN (print) / ISBN 0167-8140
e-ISSN 1879-0887
Journal Radiotherapy and Oncology
Quellenangaben Volume: 184, Issue: , Pages: , Article Number: 109678 Supplement: ,
Publisher Elsevier
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Radiation Medicine (IRM)