Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate Cancer
IntroductionProstate-specific membrane antigen-positron emission tomography-(PSMA-PET) imaging facilitates dose-escalated salvage radiotherapy (DE-SRT) with simultaneous-integrated boost (SIB) for PET-positive lesions in patients with prostate cancer (PC). Therefore, we aimed to compare toxicity rat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.715020/full |
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| author | Marco M. E. Vogel Marco M. E. Vogel Sabrina Dewes Eva K. Sage Michal Devecka Kerstin A. Eitz Kerstin A. Eitz Kerstin A. Eitz Jürgen E. Gschwend Matthias Eiber Stephanie E. Combs Stephanie E. Combs Stephanie E. Combs Kilian Schiller |
| author_facet | Marco M. E. Vogel Marco M. E. Vogel Sabrina Dewes Eva K. Sage Michal Devecka Kerstin A. Eitz Kerstin A. Eitz Kerstin A. Eitz Jürgen E. Gschwend Matthias Eiber Stephanie E. Combs Stephanie E. Combs Stephanie E. Combs Kilian Schiller |
| author_sort | Marco M. E. Vogel |
| collection | DOAJ |
| description | IntroductionProstate-specific membrane antigen-positron emission tomography-(PSMA-PET) imaging facilitates dose-escalated salvage radiotherapy (DE-SRT) with simultaneous-integrated boost (SIB) for PET-positive lesions in patients with prostate cancer (PC). Therefore, we aimed to compare toxicity rates of DE-SRT with SIB to conventional SRT (C-SRT) without SIB and to report outcome.Materials and MethodsWe evaluated 199 patients who were treated with SRT between June 2014 and June 2020. 101 patients received DE-SRT with SIB for PET-positive local recurrence and/or PET-positive lymph nodes. 98 patients were treated with C-SRT to the prostate bed +/− elective pelvic lymphatic pathways without SIB. All patients received PSMA-PET imaging prior to DE-SRT ([68Ga]PSMA-11: 45.5%; [18F]-labeled PSMA: 54.5%). Toxicity rates for early (<6 months) and late (>6 months) gastrointestinal (GI) toxicities rectal bleeding, proctitis, stool incontinence, and genitourinary (GU) toxicities hematuria, cystitis, urine incontinence, urinary obstruction, and erectile dysfunction were assessed. Further, we analyzed the outcome with disease-free survival (DFS) and prostate-specific antigen (PSA) response.ResultsThe overall toxicity rates for early GI (C-SRT: 2.1%, DE-SRT: 1.0%) and late GI (C-SRT: 1.4%, DE-SRT: 5.3%) toxicities ≥ grade 2 were similar. Early GU (C-SRT: 2.1%, DE-SRT: 3.0%) and late GU (C-SRT: 11.0%, DE-SRT: 14.7%) toxicities ≥ grade 2 were comparable, as well. Early and late toxicity rates did not differ significantly between DE-SRT versus C-SRT in all subcategories (p>0.05). PSA response (PSA ≤0.2 ng/ml) in the overall group of patients with DE-SRT was 75.0% and 86.4% at first and last follow-up, respectively.ConclusionDE-SRT showed no significantly increased toxicity rates compared with C-SRT and thus is feasible. The outcome of DE-SRT showed good results. Therefore, DE-SRT with a PSMA-PET-based SIB can be considered for the personalized treatment in patients with recurrent PC. |
| first_indexed | 2024-12-21T17:31:24Z |
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| language | English |
| last_indexed | 2024-12-21T17:31:24Z |
| publishDate | 2021-07-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-dbe4133cb1d842319053532aaee1b2402022-12-21T18:55:54ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-07-011110.3389/fonc.2021.715020715020Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate CancerMarco M. E. Vogel0Marco M. E. Vogel1Sabrina Dewes2Eva K. Sage3Michal Devecka4Kerstin A. Eitz5Kerstin A. Eitz6Kerstin A. Eitz7Jürgen E. Gschwend8Matthias Eiber9Stephanie E. Combs10Stephanie E. Combs11Stephanie E. Combs12Kilian Schiller13Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyInstitute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, GermanyDepartment of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyDepartment of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyDepartment of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyDepartment of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyInstitute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, GermanyDeutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, GermanyDepartment of Urology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyDepartment of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyDepartment of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyInstitute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, GermanyDeutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, GermanyDepartment of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, GermanyIntroductionProstate-specific membrane antigen-positron emission tomography-(PSMA-PET) imaging facilitates dose-escalated salvage radiotherapy (DE-SRT) with simultaneous-integrated boost (SIB) for PET-positive lesions in patients with prostate cancer (PC). Therefore, we aimed to compare toxicity rates of DE-SRT with SIB to conventional SRT (C-SRT) without SIB and to report outcome.Materials and MethodsWe evaluated 199 patients who were treated with SRT between June 2014 and June 2020. 101 patients received DE-SRT with SIB for PET-positive local recurrence and/or PET-positive lymph nodes. 98 patients were treated with C-SRT to the prostate bed +/− elective pelvic lymphatic pathways without SIB. All patients received PSMA-PET imaging prior to DE-SRT ([68Ga]PSMA-11: 45.5%; [18F]-labeled PSMA: 54.5%). Toxicity rates for early (<6 months) and late (>6 months) gastrointestinal (GI) toxicities rectal bleeding, proctitis, stool incontinence, and genitourinary (GU) toxicities hematuria, cystitis, urine incontinence, urinary obstruction, and erectile dysfunction were assessed. Further, we analyzed the outcome with disease-free survival (DFS) and prostate-specific antigen (PSA) response.ResultsThe overall toxicity rates for early GI (C-SRT: 2.1%, DE-SRT: 1.0%) and late GI (C-SRT: 1.4%, DE-SRT: 5.3%) toxicities ≥ grade 2 were similar. Early GU (C-SRT: 2.1%, DE-SRT: 3.0%) and late GU (C-SRT: 11.0%, DE-SRT: 14.7%) toxicities ≥ grade 2 were comparable, as well. Early and late toxicity rates did not differ significantly between DE-SRT versus C-SRT in all subcategories (p>0.05). PSA response (PSA ≤0.2 ng/ml) in the overall group of patients with DE-SRT was 75.0% and 86.4% at first and last follow-up, respectively.ConclusionDE-SRT showed no significantly increased toxicity rates compared with C-SRT and thus is feasible. The outcome of DE-SRT showed good results. Therefore, DE-SRT with a PSMA-PET-based SIB can be considered for the personalized treatment in patients with recurrent PC.https://www.frontiersin.org/articles/10.3389/fonc.2021.715020/fullsimultaneous-integrated boostrelapsepositron emission tomographyprostate-specific membrane antigenside effectsdisease-free survival |
| spellingShingle | Marco M. E. Vogel Marco M. E. Vogel Sabrina Dewes Eva K. Sage Michal Devecka Kerstin A. Eitz Kerstin A. Eitz Kerstin A. Eitz Jürgen E. Gschwend Matthias Eiber Stephanie E. Combs Stephanie E. Combs Stephanie E. Combs Kilian Schiller Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate Cancer Frontiers in Oncology simultaneous-integrated boost relapse positron emission tomography prostate-specific membrane antigen side effects disease-free survival |
| title | Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate Cancer |
| title_full | Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate Cancer |
| title_fullStr | Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate Cancer |
| title_full_unstemmed | Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate Cancer |
| title_short | Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate Cancer |
| title_sort | feasibility and outcome of psma pet based dose escalated salvage radiotherapy versus conventional salvage radiotherapy for patients with recurrent prostate cancer |
| topic | simultaneous-integrated boost relapse positron emission tomography prostate-specific membrane antigen side effects disease-free survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.715020/full |
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