Journal Article

DKFZ-2023-00497

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png PSMA-PET/CT-guided salvage radiotherapy in recurrent or persistent prostate cancer and PSA < 0.2 ng/ml.

Solomonidou, N. ; Germanou, D. ; Strouthos, I. ; Karagiannis, E. ; Farolfi, A. ; Koerber, S. A.DKFZ* ; Debus, J.DKFZ* ; Peeken, J. C.DKFZ* ; Vogel, M. E.DKFZ* ; Vrachimis, A. ; Spohn, S. K. B.DKFZ* ; Shelan, M. ; Aebersold, D. ; Grosu, A.-L.DKFZ* ; 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.DKFZ*

2023
Springer-Verl. Heidelberg [u.a.]

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Please use a persistent id in citations: doi:10.1007/s00259-023-06185-5

Abstract: 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.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.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.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.

Keyword(s): PSMA-PET ; Prostate cancer ; Prostate-specific antigen ; Salvage radiotherapy

Note: 2023 Jul;50(8):2529-2536

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Contributing Institute(s):

1. E050 KKE Strahlentherapie (E050)
2. DKTK MU LMU zentral (MU01)
3. DKTK FR zentral (FR01)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2023

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Springer ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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