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

BACKGROUND: 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 tho...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191762/
https://www.ncbi.nlm.nih.gov/pubmed/32349700
http://dx.doi.org/10.1186/s12885-020-06883-5
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author 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
author_facet 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
author_sort Oehus, Ann-Kathrin
collection PubMed
description BACKGROUND: 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). METHODS: 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. RESULTS: 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; p < 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 (p = 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 (p = 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. CONCLUSIONS: 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.
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spelling pubmed-71917622020-05-04 Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy 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 BMC Cancer Research Article BACKGROUND: 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). METHODS: 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. RESULTS: 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; p < 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 (p = 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 (p = 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. CONCLUSIONS: 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. BioMed Central 2020-04-29 /pmc/articles/PMC7191762/ /pubmed/32349700 http://dx.doi.org/10.1186/s12885-020-06883-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
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
Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
title Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
title_full Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
title_fullStr Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
title_full_unstemmed Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
title_short Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
title_sort efficacy of psma ligand pet-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191762/
https://www.ncbi.nlm.nih.gov/pubmed/32349700
http://dx.doi.org/10.1186/s12885-020-06883-5
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