Journal Article

DKFZ-2024-01680

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png PSMA-PET/CT response after metastasis-directed radiotherapy of bone oligometastases in prostate cancer.

Sheikh, G. T. ; Trapp, C. ; Schmidt-Hegemann, N.-S. ; Buchner, A. ; Stief, C. G. ; Unterrainer, M. ; Kunz, W. G. ; Cyran, C. C. ; Grawe, F.DKFZ* ; Delker, A. ; Zacherl, M. J. ; Holzgreve, A. ; Unterrainer, L. M. ; Brendel, M. ; Belka, C.DKFZ* ; Li, M. ; Rogowski, P.

2024
Springer International Publishing [Cham]

Abstract: Bone metastases are very common in advanced prostate cancer and can sensitively be detected utilizing PSMA-PET/CT. Therefore, our goal was to evaluate the suitability of PSMA-PET/CT-guided metastasis-directed external beam radiotherapy (MDT) as treatment option for patients with biochemical recurrence and oligometastatic bone lesions.We retrospectively examined 32 prostate cancer patients with biochemical recurrence and PSMA-positive oligometastatic disease limited to the bone (n = 1-3). A total of 49 bone lesions were treated with MDT. All patients received a post-radiotherapy PSMA-PET/CT-Scan. Changes in SUVmax, PSMA-positive tumor volume per lesion and PSA, as well as the correlation between the PET/CT-interval and SUVmax response were calculated.MDT lead to a SUVmax decrease in 46/49 (94%) of the lesions. The median relative decline of SUVmax was 60.4%, respectively. Based on PSMA-positive lesion volume with a SUV cut-off of 4, 46/49 (94%) of lesions showed complete response, two (4%) partial response and one lesion (2%) was stable on PSMA-PET/CT after MDT. Most of the treated patients (56.3%) showed an initial PSA decline at three months and a PSA nadir of median 0.14 ng/ml after a median time of 3.6 months after MDT. The median relative PSA change at three months after MDT was 3.9%.MDT is a very effective treatment modality for prostate cancer bone oligometastases and lesion response to MDT can be assessed using the (semi-)quantitative parameters SUVmax and PSMA-positive lesion volume with established SUV cut-offs.

Keyword(s): Metastases directed therapy (MDT) ; Oligometastatic prostate cancer (OMPC) ; PET/CT ; Prostate specific membrane antigen (PSMA) ; Response assessment

Note: EJNMMI Reports (EJNMMI Rep.) = 3005-074X (import from CrossRef, PubMed, , Journals: inrepo02.dkfz.de)

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Contributing Institute(s):

1. NWG KKE Translationale Molekulare Bildgebung im Onkologischen Therapiemonitoring (E310)
2. DKTK Koordinierungsstelle München (MU01)

Research Program(s):

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

Appears in the scientific report 2024

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