Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy
Oehus AK, Kroeze SGC, Schmidt-Hegemann NS, Vogel MME, Kirste S, Becker J, Burger IA, Derlin T, Bartenstein P, Eiber M, Mix M, La Fougere C, Belka C, Combs SE, Grosu AL, Mueller AC, Guckenberger M, Christiansen H, Henkenberens C (2020)
Publication Type: Journal article
Publication year: 2020
Journal
Book Volume: 20
Article Number: 362
Journal Issue: 1
DOI: 10.1186/s12885-020-06883-5
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.
Involved external institutions
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
University of Zurich / Universität Zürich (UZH)
Switzerland (CH)
Universitätsklinikum der Ludwig-Maximilians-Universität München
Germany (DE)
Technische Universität München (TUM)
Germany (DE)
Albert-Ludwigs-Universität Freiburg
Germany (DE)
Universitätsklinikum Tübingen
Germany (DE)
Universitätsspital Zürich (USZ)
Switzerland (CH)
Germany (DE)
University of Zurich / Universität Zürich (UZH)
Switzerland (CH)
Universitätsklinikum der Ludwig-Maximilians-Universität München
Germany (DE)
Technische Universität München (TUM)
Germany (DE)
Albert-Ludwigs-Universität Freiburg
Germany (DE)
Universitätsklinikum Tübingen
Germany (DE)
Universitätsspital Zürich (USZ)
Switzerland (CH)
How to cite
APA:
Oehus, A.-K., Kroeze, S.G.C., Schmidt-Hegemann, N.-S., Vogel, M.M.E., Kirste, S., Becker, J.,... Henkenberens, C. (2020). Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy. BMC Cancer, 20(1). https://doi.org/10.1186/s12885-020-06883-5
MLA:
Oehus, Ann-Kathrin, et al. "Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy." BMC Cancer 20.1 (2020).
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