Impact of (68)Ga-PSMA PET/CT on salvage radiotherapy planning in patients with prostate cancer and persisting PSA values or biochemical relapse after prostatectomy.

Bluemel, Christina; Linke, Fraenze; Herrmann, Ken; Simunovic, Iva; Eiber, Matthias; Kestler, Christian; Buck, Andreas K; Schirbel, Andreas; Bley, Thorsten A; Wester, Hans-Juergen; Vergho, Daniel; Becker, Axel

doi:10.1186/s13550-016-0233-4

journal article

Titel:: Impact of (68)Ga-PSMA PET/CT on salvage radiotherapy planning in patients with prostate cancer and persisting PSA values or biochemical relapse after prostatectomy.
Dokumenttyp:: Journal Article
Autor(en):: Bluemel, Christina; Linke, Fraenze; Herrmann, Ken; Simunovic, Iva; Eiber, Matthias; Kestler, Christian; Buck, Andreas K; Schirbel, Andreas; Bley, Thorsten A; Wester, Hans-Juergen; Vergho, Daniel; Becker, Axel
Abstract:: Salvage radiotherapy (SRT) is clinically established in prostate cancer (PC) patients with PSA persistence or biochemical relapse (BCR) after prior radical surgery. PET/CT imaging prior to SRT may be performed to localize disease recurrence. The recently introduced (68)Ga-PSMA outperforms other PET tracers for detection of recurrence and is therefore expected also to impact radiation planning. Forty-five patients with PSA persistence (16 pts) or BCR (29 pts) after prior prostatectomy, scheduled to undergo SRT of the prostate bed, underwent (68)Ga-PSMA PET/CT. The median PSA level was 0.67 ng/ml. The impact of (68)Ga-PSMA PET/CT on the treatment decision was assessed. Patients with oligometastatic (<=5 lesions) PC underwent radiotherapy (RT), with the extent of the RT area and dose escalation being based on PET positivity.Suspicious lesions were detected in 24/45 (53.3 %) patients. In 62.5 % of patients, lesions were only detected by (68)Ga-PSMA PET. Treatment was changed in 19/45 (42.2 %) patients, e.g., extending SRT to metastases (9/19), administering dose escalation in patients with morphological local recurrence (6/19), or replacing SRT by systemic therapy (2/19). 38/45 (84.4 %) followed the treatment recommendation, with data on clinical follow-up being available in 21 patients treated with SRT. All but one showed biochemical response (mean PSA decline 78 ± 19 %) within a mean follow-up of 8.12 ± 5.23 months.(68)Ga-PSMA PET/CT impacts treatment planning in more than 40 % of patients scheduled to undergo SRT. Future prospective studies are needed to confirm this significant therapeutic impact on patients prior to SRT.
Zeitschriftentitel:: EJNMMI Res
Jahr:: 2016
Band / Volume:: 6
Heft / Issue:: 1
Seitenangaben Beitrag:: 78
Sprache:: eng
Volltext / DOI:: doi:10.1186/s13550-016-0233-4
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/27785766
Print-ISSN:: 2191-219X
TUM Einrichtung:: Klinik und Poliklinik für Nuklearmedizin
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Nuklearmedizin (Prof. Weber)2016