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 < 0.2 ng/ml. Methods: 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. 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 66–70 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. 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.

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.; 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.. - In: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. - ISSN 1619-7070. - ELETTRONICO. - 50:8(2023), pp. 2529-2536. [10.1007/s00259-023-06185-5]

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

Ceci F.;Fanti S.;
2023

Abstract

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 < 0.2 ng/ml. Methods: 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. 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 66–70 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. 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.
2023
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.; 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.. - In: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. - ISSN 1619-7070. - ELETTRONICO. - 50:8(2023), pp. 2529-2536. [10.1007/s00259-023-06185-5]
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.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/957717
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