68Ga-PSMA-11 PET/CT-Guided Stereotactic Body Radiation Therapy Retreatment in Prostate Cancer Patients with PSA Failure after Salvage Radiotherapy

(1) Purpose: To investigate the role of 68Ga-PSMA-11 PET/CT in guiding retreatment stereotactic body radiation therapy (SBRT) in prostate cancer (PCa) patients in biochemical recurrence (BCR) after salvage radiotherapy (S-RT). (2) Methods: We retrospectively evaluated PCa patients previously treated with S-RT on the prostate bed and with proven serum prostate antigen (PSA) failure after S-RT. In all patients (pts), 68Ga-PSMA-11 PET/CT was positive in the prostate bed only and guided retreatment SBRT. All retreatments were performed by applying the same radiotherapy protocol (median dose of 18 Gy/3 fractions; IQR 18–21 Gy). The median follow-up was 27 months (range 4–35 months). (3) Results: 38 consecutive patients were considered in this analysis. The overall median PSA level before RT was 1.10 ng/mL (IQR 0.82–2.59). PSA decreased at 3 and 6 months after treatment, with a median value of 0.60 ng/mL (IQR 0.31–0.96; p < 0.001) and 0.51 ng/mL (IQR 0.29–1.17; p < 0.001), respectively. Overall, biochemical recurrence-free survival (b-RFS) was 15.0 months (95% CI 13–23). Grade-1 toxicity was reported in 31.6% of patients (12/38). (4) Conclusion: These results confirm that 68Ga-PSMA-11-PET/CT is able to identify the site of recurrence in patients who have failed S-RT, thus supporting the use of metastases-directed radiotherapy as a safe and effective treatment.

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EP-1518: 18F-NaF PET/CT-guided boost stereotactic body radiation therapy for bone metastases from prostate cancer

Radiotherapy and Oncology ◽

10.1016/s0167-8140(15)41510-5 ◽

2015 ◽

Vol 115 ◽

pp. S827-S829

Author(s):

L. Wu ◽

J. Lu ◽

S. Kwee ◽

M. Li ◽

X. Peng ◽

...

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Bone Metastases ◽

Stereotactic Body Radiation Therapy ◽

Ct Guided ◽

Stereotactic Body Radiation ◽

Pet Ct

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SU-F-J-101: Stereotactic Body Radiation Therapy Planning for Primary Prostate Cancer with Selective Intraprostatic Boost Determined by 18F-Choline PET/CT

Medical Physics ◽

10.1118/1.4956009 ◽

2016 ◽

Vol 43 (6Part10) ◽

pp. 3430-3430

Author(s):

L Wu ◽

H Wang ◽

E Hirata ◽

S Kwee ◽

Y Kuang

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Stereotactic Body Radiation Therapy ◽

Therapy Planning ◽

Stereotactic Body Radiation ◽

Choline Pet ◽

Radiation Therapy Planning ◽

Primary Prostate Cancer ◽

Pet Ct

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Prostate Bed Stereotactic Body Radiation Therapy (PB-SBRT) for Postprostatectomy Biochemical Recurrence: First Toxicity Results of a Phase 1 Dose-Escalation Trial

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2016.06.1197 ◽

2016 ◽

Vol 96 (2) ◽

pp. E227-E228 ◽

Cited By ~ 2

Author(s):

S. Sampath ◽

B. Yuh ◽

P. Frankel ◽

A. Liu ◽

P. Tsai ◽

...

Keyword(s):

Radiation Therapy ◽

Dose Escalation ◽

Biochemical Recurrence ◽

Stereotactic Body Radiation Therapy ◽

Phase 1 ◽

Stereotactic Body Radiation ◽

Prostate Bed

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Combining 68Ga-PSMA-PET/CT-Directed and Elective Radiation Therapy Improves Outcome in Oligorecurrent Prostate Cancer: A Retrospective Multicenter Study

Frontiers in Oncology ◽

10.3389/fonc.2021.640467 ◽

2021 ◽

Vol 11 ◽

Author(s):

Simon Kirste ◽

Stephanie G. C. Kroeze ◽

Christoph Henkenberens ◽

Nina-Sophie Schmidt-Hegemann ◽

Marco M. E. Vogel ◽

...

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Multicenter Study ◽

Recurrent Prostate Cancer ◽

Ct Guided ◽

Prostate Bed ◽

Psma Pet ◽

Pet Ct ◽

Grade 3 ◽

Retrospective Multicenter Study

BackgroundIn case of oligo-recurrent prostate cancer (PC) following prostatectomy, 68Ga-PSMA-PET/CT can be used to detect a specific site of recurrence and to initiate metastasis-directed radiation therapy (MDT). However, large heterogeneities exist concerning doses, treatment fields and radiation techniques, with some studies reporting focal radiotherapy (RT) to PSMA-PET/CT positive lesions only and other studies using elective RT strategies. We aimed to compare oncological outcomes and toxicity between PET/CT-directed RT (PDRT) and PDRT plus elective RT (eRT; i.e. prostate bed, pelvic or paraaortal nodes) in a large retrospective multicenter study.MethodsData of 394 patients with oligo-recurrent 68Ga-PSMA-PET/CT-positive PC treated between 04/2013 and 01/2018 in six different academic institutions were evaluated. Primary endpoint was biochemical-recurrence-free survival (bRFS). bRFS was analyzed using Kaplan–Meier survival curves and log rank testing. Uni- and multivariate analyses were performed to determine influence of treatment parameters.ResultsIn 204 patients (51.8%) RT was directed only to lesions seen on 68Ga-PSMA-PET/CT (PDRT), 190 patients (48.2%) received PDRT plus eRT. PDRT plus eRT was associated with a significantly improved 3-year bRFS compared to PDRT alone (53 vs. 37%; p = 0.001) and remained an independent factor in multivariate analysis (p = 0.006, HR 0.29, 95% CI 0.12–0.68). This effect was more pronounced in the subgroup of patients who were treated with PDRT and elective prostate bed radiotherapy (ePBRT) with a 3-year bRFS of 61% versus 22% (p <0.001). Acute and late toxicity grade ≥3 was 0.8% and 3% after PDRT plus eRT versus no toxicity grade ≥3 after PDRT alone.ConclusionsIn this large cohort of patients with oligo-recurrent prostate cancer, elective irradiation of the pelvic lymphatics and the prostatic bed significantly improved bRFS when added to 68Ga-PSMA-PET/CT-guided focal radiotherapy. These findings need to be evaluated in a randomized controlled trial.

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