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037 _ _ |a DKFZ-2023-00497
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100 1 _ |a Solomonidou, Nantia
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245 _ _ |a PSMA-PET/CT-guided salvage radiotherapy in recurrent or persistent prostate cancer and PSA < 0.2 ng/ml.
260 _ _ |a Heidelberg [u.a.]
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500 _ _ |a 2023 Jul;50(8):2529-2536
520 _ _ |a 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.
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650 _ 7 |a Prostate cancer
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650 _ 7 |a Prostate-specific antigen
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650 _ 7 |a Salvage radiotherapy
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700 1 _ |a Germanou, Daphnie
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700 1 _ |a Strouthos, Iosif
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700 1 _ |a Karagiannis, Efstratios
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700 1 _ |a Farolfi, Andrea
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700 1 _ |a Koerber, Stefan A
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700 1 _ |a Peeken, Jan C
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700 1 _ |a Vogel, Marco E
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700 1 _ |a Vrachimis, Alexis
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700 1 _ |a Spohn, Simon K B
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700 1 _ |a Shelan, Mohamed
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700 1 _ |a Aebersold, Daniel
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700 1 _ |a Grosu, Anca-Ligia
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700 1 _ |a Ceci, Francesco
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700 1 _ |a Kroeze, Stephanie G C
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700 1 _ |a Guckenberger, Matthias
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700 1 _ |a Fanti, Stefano
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700 1 _ |a Belka, Claus
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700 1 _ |a Hruby, George
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700 1 _ |a Scharl, S.
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700 1 _ |a Wiegel, Thomas
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700 1 _ |a Bartenstein, Peter
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700 1 _ |a Henkenberens, Christoph
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700 1 _ |a Emmett, Louise
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700 1 _ |a Schmidt-Hegemann, Nina Sophie
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700 1 _ |a Ferentinos, Konstantinos
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700 1 _ |a Zamboglou, Constantinos
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