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Salvage Radiotherapy PSMA PET/CT-guided in Men With PSA Recurrence.

Maria Tamburo1, Emanuele Buffettino2, Pietro Pepe3

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|April 27, 2024
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Summary

Salvage radiotherapy guided by PSMA PET/CT achieved local control in nearly 70% of men with recurrent prostate cancer within one year. This approach enables early treatment for prostate cancer recurrence, even with low PSA levels.

Keywords:
PCa recurrencePSA failurePSMA PET/CTSalvage radiotherapy

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiotherapy

Background:

  • Recurrent prostate cancer (PCa) poses a significant clinical challenge.
  • Salvage radiotherapy (sRT) is a treatment option for PCa recurrence.
  • Accurate staging is crucial for effective sRT planning.

Purpose of the Study:

  • To evaluate the clinical outcomes of men with recurrent prostate cancer treated with PSMA PET/CT-guided sRT.
  • To assess the efficacy of sRT based on the location and extent of PCa recurrence.

Main Methods:

  • A cohort of 33 patients with recurrent PCa underwent sRT guided by 18F-PSMA PET/CT.
  • Patients received sRT targeting prostate bed (PB), lymph node (LN), or bone metastases.
  • Prostate-specific antigen (PSA) levels and SUVmax on PSMA PET/CT were recorded.

Main Results:

  • At a median follow-up of 12 months, 69.7% of patients achieved local control without distant progression.
  • Higher local control rates were observed for sRT targeting the prostate bed (87.5%) compared to lymph nodes (58.3%) and bone (40%).
  • Median SUVmax values varied by recurrence site: PB (12.5), LN (19.0), and bone (30.1).

Conclusions:

  • PSMA PET/CT-guided sRT is effective in managing recurrent prostate cancer.
  • This imaging modality allows for early intervention in men with PCa recurrence and low PSA values.
  • Approximately 70% of patients achieve a complete clinical response one year post-treatment.