Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
Abstract 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...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-04-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12885-020-06883-5 |
| _version_ | 1811286554084114432 |
|---|---|
| author | Ann-Kathrin Oehus Stephanie G. C. Kroeze Nina-Sophie Schmidt-Hegemann Marco M. E. Vogel Simon Kirste Jessica Becker Irene A. Burger Thorsten Derlin Peter Bartenstein Matthias Eiber Michael Mix Christian la Fougère Claus Belka Stephanie E. Combs Anca-Ligia Grosu Arndt-Christian Müller Matthias Guckenberger Hans Christiansen Christoph Henkenberens |
| author_facet | Ann-Kathrin Oehus Stephanie G. C. Kroeze Nina-Sophie Schmidt-Hegemann Marco M. E. Vogel Simon Kirste Jessica Becker Irene A. Burger Thorsten Derlin Peter Bartenstein Matthias Eiber Michael Mix Christian la Fougère Claus Belka Stephanie E. Combs Anca-Ligia Grosu Arndt-Christian Müller Matthias Guckenberger Hans Christiansen Christoph Henkenberens |
| author_sort | Ann-Kathrin Oehus |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-13T03:02:15Z |
| format | Article |
| id | doaj.art-4167d02b874f498b84f9a59fe52aabbd |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T03:02:15Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-4167d02b874f498b84f9a59fe52aabbd2022-12-22T03:05:24ZengBMCBMC Cancer1471-24072020-04-012011910.1186/s12885-020-06883-5Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapyAnn-Kathrin Oehus0Stephanie G. C. Kroeze1Nina-Sophie Schmidt-Hegemann2Marco M. E. Vogel3Simon Kirste4Jessica Becker5Irene A. Burger6Thorsten Derlin7Peter Bartenstein8Matthias Eiber9Michael Mix10Christian la Fougère11Claus Belka12Stephanie E. Combs13Anca-Ligia Grosu14Arndt-Christian Müller15Matthias Guckenberger16Hans Christiansen17Christoph Henkenberens18Department of Radiotherapy and Special Oncology, Hannover Medical SchoolDepartment of Radiation Oncology, University Hospital Zürich, University of ZurichDepartment of Radiation Oncology, University Hospital LMU MunichDepartment of Radiation Oncology, Technical University MunichDepartment of Radiation Oncology, University of FreiburgDepartment of Radiation Oncology, University Hospital TübingenDepartment of Nuclear Medicine, University Hospital ZürichDepartment of Nuclear Medicine, Hannover Medical SchoolDepartment of Nuclear Medicine, University Hospital LMU MunichDepartment of Nuclear Medicine, Technical University MunichDepartment of Nuclear Medicine, University of FreiburgDepartment of Nuclear Medicine, University Hospital TübingenDepartment of Radiation Oncology, University Hospital LMU MunichDepartment of Radiation Oncology, Technical University MunichDepartment of Radiation Oncology, University of FreiburgDepartment of Radiation Oncology, University Hospital TübingenDepartment of Radiation Oncology, University Hospital Zürich, University of ZurichDepartment of Radiotherapy and Special Oncology, Hannover Medical SchoolDepartment of Radiotherapy and Special Oncology, Hannover Medical SchoolAbstract 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.http://link.springer.com/article/10.1186/s12885-020-06883-5PSMARadiotherapyProstate cancerOligometastasesRecurrenceRadical prostatectomy |
| spellingShingle | Ann-Kathrin Oehus Stephanie G. C. Kroeze Nina-Sophie Schmidt-Hegemann Marco M. E. Vogel Simon Kirste Jessica Becker Irene A. Burger Thorsten Derlin Peter Bartenstein Matthias Eiber Michael Mix Christian la Fougère Claus Belka Stephanie E. Combs Anca-Ligia Grosu Arndt-Christian Müller Matthias Guckenberger Hans Christiansen Christoph Henkenberens Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy BMC Cancer PSMA Radiotherapy Prostate cancer Oligometastases Recurrence Radical prostatectomy |
| 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 | PSMA Radiotherapy Prostate cancer Oligometastases Recurrence Radical prostatectomy |
| url | http://link.springer.com/article/10.1186/s12885-020-06883-5 |
| work_keys_str_mv | AT annkathrinoehus efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT stephaniegckroeze efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT ninasophieschmidthegemann efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT marcomevogel efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT simonkirste efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT jessicabecker efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT ireneaburger efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT thorstenderlin efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT peterbartenstein efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT matthiaseiber efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT michaelmix efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT christianlafougere efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT clausbelka efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT stephanieecombs efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT ancaligiagrosu efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT arndtchristianmuller efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT matthiasguckenberger efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT hanschristiansen efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy AT christophhenkenberens efficacyofpsmaligandpetbasedradiotherapyforrecurrentprostatecancerafterradicalprostatectomyandsalvageradiotherapy |