Journal Article

DKFZ-2023-00922

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Salvage radiotherapy is effective in patients with PSMA-PET-negative biochemical recurrence- results of a retrospective study.

Scharl, S. ; Zamboglou, C.DKFZ* ; Strouthos, I. ; Farolfi, A. ; Serani, F. ; Lanzafame, H. ; Giuseppe Morganti, A. ; Trapp, C. ; Koerber, S. A.DKFZ* ; Debus, J.DKFZ* ; Peeken, J. C.DKFZ* ; Vogel, M. M. E.DKFZ* ; Vrachimis, A. ; K B Spohn, S.DKFZ* ; Ruf, J.DKFZ* ; Grosu, A.-L.DKFZ* ; 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.

2023
Elsevier Science Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.radonc.2023.109678

Abstract: /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).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.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.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.

Keyword(s): PET negative ; PSMA PET-CT ; prostate cancer ; salvage radiotherapy

Note: 2023 Jul;184:109678

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Freiburg (FR01)
2. E050 KKE Strahlentherapie (E050)
3. DKTK Koordinierungsstelle München (MU01)

Research Program(s):

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

Appears in the scientific report 2023

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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