학술논문
PSMA-PET/CT-guided salvage radiotherapy in recurrent or persistent prostate cancer and PSA < 0.2 ng/ml
Document Type
Original Paper
Author
Solomonidou, Nantia; Germanou, Daphnie; Strouthos, Iosif; Karagiannis, Efstratios; Farolfi, Andrea; Koerber, Stefan A.; Debus, Juergen; Peeken, Jan C.; Vogel, Marco E.; Vrachimis, Alexis; Spohn, Simon K. B.; Shelan, Mohamed; Aebersold, Daniel; Grosu, Anca-Ligia; Ceci, Francesco; Kroeze, Stephanie G. C.; Guckenberger, Matthias; Fanti, Stefano; Belka, Claus; Hruby, George; Scharl, S.; Wiegel, Thomas; Bartenstein, Peter; Henkenberens, Christoph; Emmett, Louise; Schmidt-Hegemann, Nina Sophie; Ferentinos, Konstantinos; Zamboglou, Constantinos
Source
European Journal of Nuclear Medicine and Molecular Imaging. :1-8
Subject
Language
English
ISSN
1619-7070
1619-7089
1619-7089
Abstract
Abstract: 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.