Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy

Media type: E-Article
Title: Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
Contributor: Oehus, Ann-Kathrin; Kroeze, Stephanie G. C.; Schmidt-Hegemann, Nina-Sophie; Vogel, Marco M. E.; Kirste, Simon; Becker, Jessica; Burger, Irene A.; Derlin, Thorsten; Bartenstein, Peter; Eiber, Matthias; Mix, Michael; la Fougère, Christian; Belka, Claus; Combs, Stephanie E.; Grosu, Anca-Ligia; Müller, Arndt-Christian; Guckenberger, Matthias; Christiansen, Hans; Henkenberens, Christoph
imprint: Springer Science and Business Media LLC, 2020
Published in: BMC Cancer
Language: English
DOI: 10.1186/s12885-020-06883-5
ISSN: 1471-2407
Keywords: Cancer Research ; Genetics ; Oncology
Origination:
Footnote:
Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>A substantial number of patients will develop further biochemical progression after radical prostatectomy (RP) and salvage radiotherapy (sRT). Recently published data using prostate-specific membrane antigen ligand positron emission tomography (PSMA - PET) for re-staging suggest that those recurrences are often located outside the prostate fossa and most of the patients have a limited number of metastases, making them amenable to metastasis-directed treatment (MDT).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>We analyzed 78 patients with biochemical progression after RP and sRT from a retrospective European multicenter database and assessed the biochemical recurrence-free survival (bRFS; PSA < nadir + 0.2 ng/ml or no PSA decline) as well as the androgen deprivation therapy- free survival (ADT-FS) using Kaplan-Meier curves. Log-rank test and multivariate analysis was performed to determine influencing factors.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 185 PSMA – PET positive metastases were detected and all lesions were treated with radiotherapy (RT). Concurrent ADT was prescribed in 16.7% (13/78) of patients. The median PSA level before RT was 1.90 ng/mL (range, 0.1–22.1) and decreased statistically significantly to a median PSA nadir level of 0.26 ng/mL (range, 0.0–12.25; <jats:italic>p</jats:italic> < 0.001). The median PSA level of 0.88 ng/mL (range, 0.0–25.8) at the last follow-up was also statistically significantly lower (<jats:italic>p</jats:italic> = 0.008) than the median PSA level of 1.9 ng/mL (range, 0.1–22.1) before RT. The median bRFS was 17.0 months (95% CI, 14.2–19.8). After 12 months, 55.3% of patients were free of biochemical progression. Multivariate analyses showed that concurrent ADT was the most important independent factor for bRFS (<jats:italic>p</jats:italic> = 0.01). The median ADT-FS was not reached and exploratory statistical analyses estimated a median ADT-FS of 34.0 months (95% CI, 16.3–51.7). Multivariate analyses revealed no significant parameters for ADT-FS.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>RT as MDT based on PSMA - PET of all metastases of recurrent prostate cancer after RP and sRT represents a viable treatment option for well-informed and well-selected patients.</jats:p> </jats:sec>
Access State: Open Access

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