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

Title: PSMA-PET/CT-guided salvage radiotherapy in recurrent or persistent prostate cancer and PSA < 0.2 ng/ml
Authors: Solomonidou N.; Germanou D.; Strouthos I.; Karagiannis E.; Farolfi A.; Koerber S. A.; Debus J.; Peeken J. C.; Vogel M. E.; 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.
Contributors: Solomonidou N.; Germanou D.; Strouthos I.; Karagiannis E.; Farolfi A.; Koerber S.A.; Debus J.; Peeken J.C.; Vogel M.E.; 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.
Publication Year: 2023
Collection: IRIS Università degli Studi di Bologna (CRIS - Current Research Information System)
Subject Terms: Prostate cancer; Prostate-specific antigen; PSMA-PET; Salvage radiotherapy
Description: 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 < 0.2ng/ml. Methods: The study included patients from a pooled cohort (n = 1223) of 11 centers from 6 countries. Patients with PSA levels > 0.2ng/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 + 0.2ng/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 66–70Gy (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 31.1months (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.
Document Type: article in journal/newspaper
File Description: ELETTRONICO
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/36905411; info:eu-repo/semantics/altIdentifier/wos/WOS:000946996000002; volume:50; issue:8; firstpage:2529; lastpage:2536; numberofpages:8; journal:EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING; https://hdl.handle.net/11585/957717
DOI: 10.1007/s00259-023-06185-5
Availability: https://hdl.handle.net/11585/957717; https://doi.org/10.1007/s00259-023-06185-5; https://link.springer.com/article/10.1007/s00259-023-06185-5
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.4D0FF8CA
Database: BASE