PURPOSE: To evaluate, in prostate cancer (PCa) patients the potential of (11)C-choline PET/CT as a guide to helical tomotherapy (HTT) of lymph-node (LN) relapses with simultaneous integrated boost (SIB). The efficacy and feasibility of HTT in terms of acute toxicity were assessed. METHODS: We enrolled 83 PCa patients (mean age 68 years, range 51 - 82 years) with biochemical recurrence after radical primary treatment (mean serum PSA 7.61 ng/ml, range 0.37 - 187.00 ng/ml; PSA0) who showed pathological findings on (11)C-choline PET/CT only at the LN site. (11)C-Choline PET/CT was performed for restaging and then for radiation treatment planning (PET/CT0). Of the 83 patients, 8 experienced further LN relapse, of whom 5 were retreated once and 3 were retreated twice (total 94 radiotherapy treatments). All pelvic and/or abdominal LNs positive on PET/CT0 were treated with high doses using SIB. Doses were in the range 36 - 74 Gy administered in 28 fractions. After the end of HTT (mean 83 days, range 16 - 365 days), serum PSA was measured in all patients (PSA1) and compared with PSA0 to evaluate early biochemical response. In 47 patients PET/CT was repeated (PET/CT1) to assess metabolic responses at the treated areas. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) were used to assess acute toxicity. RESULTS: PET/CT0 revealed pathological LNs in the pelvis in 49 patients, pathological LNs in the abdomen in 15 patients pathological LNs in both the pelvis and abdomen in 18 patients, and pathological LNs in the pelvis or abdomen and other sites in 12 patients. All these sites were treated with HTT. With respect to PSA0, PSA1 (mean 6.28 ng/ml, range 0.00 - 220.46 ng/ml) showed a complete biochemical response after 66 of the 94 HTT treatments, a partial response after 12 treatments, stable disease after 1 treatment and progression of disease after 15 treatments. Of the 47 patients receiving PET/CT1, 20 showed a complete metabolic response at the treated area, 22 a partial metabolic response, 3 progression of disease and 2 stable disease. HTT with SIB was well tolerated in all patients. Grade 3 acute toxicity in the genitourinary tract was observed in two patients. CONCLUSION: (11)C-Choline PET/CT is a valuable tool for planning and monitoring HTT in LN relapse after primary treatment. High-dose hypofractionated (11)C-choline PET/CT-guided HTT with SIB is well tolerated and is associated with a high early biochemical response rate.
PURPOSE: To evaluate, in prostate cancer (PCa) patients the potential of (11)C-choline PET/CT as a guide to helical tomotherapy (HTT) of lymph-node (LN) relapses with simultaneous integrated boost (SIB). The efficacy and feasibility of HTT in terms of acute toxicity were assessed. METHODS: We enrolled 83 PCa patients (mean age 68 years, range 51 - 82 years) with biochemical recurrence after radical primary treatment (mean serum PSA 7.61 ng/ml, range 0.37 - 187.00 ng/ml; PSA0) who showed pathological findings on (11)C-choline PET/CT only at the LN site. (11)C-Choline PET/CT was performed for restaging and then for radiation treatment planning (PET/CT0). Of the 83 patients, 8 experienced further LN relapse, of whom 5 were retreated once and 3 were retreated twice (total 94 radiotherapy treatments). All pelvic and/or abdominal LNs positive on PET/CT0 were treated with high doses using SIB. Doses were in the range 36 - 74 Gy administered in 28 fractions. After the end of HTT (mean 83 days, range 16 - 365 days), serum PSA was measured in all patients (PSA1) and compared with PSA0 to evaluate early biochemical response. In 47 patients PET/CT was repeated (PET/CT1) to assess metabolic responses at the treated areas. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) were used to assess acute toxicity. RESULTS: PET/CT0 revealed pathological LNs in the pelvis in 49 patients, pathological LNs in the abdomen in 15 patients pathological LNs in both the pelvis and abdomen in 18 patients, and pathological LNs in the pelvis or abdomen and other sites in 12 patients. All these sites were treated with HTT. With respect to PSA0, PSA1 (mean 6.28 ng/ml, range 0.00 - 220.46 ng/ml) showed a complete biochemical response after 66 of the 94 HTT treatments, a partial response after 12 treatments, stable disease after 1 treatment and progression of disease after 15 treatments. Of the 47 patients receiving PET/CT1, 20 showed a complete metabolic response at the treated area, 22 a partial metabolic response, 3 progression of disease and 2 stable disease. HTT with SIB was well tolerated in all patients. Grade 3 acute toxicity in the genitourinary tract was observed in two patients. CONCLUSION: (11)C-Choline PET/CT is a valuable tool for planning and monitoring HTT in LN relapse after primary treatment. High-dose hypofractionated (11)C-choline PET/CT-guided HTT with SIB is well tolerated and is associated with a high early biochemical response rate.
Authors: V Bettinardi; P Mancosu; M Danna; G Giovacchini; C Landoni; M Picchio; M C Gilardi; A Savi; I Castiglioni; M Lecchi; F Fazio Journal: Q J Nucl Med Mol Imaging Date: 2007-04-30 Impact factor: 2.346
Authors: Axel Heidenreich; Joaquim Bellmunt; Michel Bolla; Steven Joniau; Malcolm Mason; Vsevolod Matveev; Nicolas Mottet; Hans-Peter Schmid; Theo van der Kwast; Thomas Wiegel; Filliberto Zattoni Journal: Eur Urol Date: 2010-10-28 Impact factor: 20.096
Authors: Michael Pinkawa; Marc D Piroth; Richard Holy; Victoria Djukic; Jens Klotz; Barbara Krenkel; Michael J Eble Journal: Strahlenther Onkol Date: 2011-07-25 Impact factor: 3.621
Authors: M A Pantaleo; M Nannini; E Lopci; P Castellucci; A Maleddu; F Lodi; C Nanni; V Allegri; M Astorino; G Brandi; M Di Battista; S Boschi; S Fanti; G Biasco Journal: Int J Oncol Date: 2008-09 Impact factor: 5.650
Authors: Sean E McGuire; Andrew K Lee; Jasmina Z Cerne; Mark F Munsell; Lawrence B Levy; Rajat J Kudchadker; Seungtaek L Choi; Quynh N Nguyen; Karen E Hoffman; Thomas J Pugh; Steven J Frank; Paul G Corn; Christopher J Logothetis; Deborah A Kuban Journal: Int J Radiat Oncol Biol Phys Date: 2012-10-23 Impact factor: 7.038
Authors: Padraig Warde; Malcolm Mason; Keyue Ding; Peter Kirkbride; Michael Brundage; Richard Cowan; Mary Gospodarowicz; Karen Sanders; Edmund Kostashuk; Greg Swanson; Jim Barber; Andrea Hiltz; Mahesh K B Parmar; Jinka Sathya; John Anderson; Charles Hayter; John Hetherington; Matthew R Sydes; Wendy Parulekar Journal: Lancet Date: 2011-11-02 Impact factor: 79.321
Authors: Christoph Henkenberens; Axel S Merseburger; Frank Bengel; Thorsten Derlin; Katja Hueper; Viktor Grünwald; Hans Christiansen Journal: World J Urol Date: 2015-11-27 Impact factor: 4.226
Authors: Christoph Henkenberens; Christoph A von Klot; Tobias L Ross; Frank M Bengel; Hans-Jürgen Wester; Axel S Merseburger; Jens Vogel-Claussen; Hans Christiansen; Thorsten Derlin Journal: Strahlenther Onkol Date: 2016-06-07 Impact factor: 3.621
Authors: Francesco Ceci; Christian Uprimny; Bernhard Nilica; Llanos Geraldo; Dorota Kendler; Alexander Kroiss; Jasmin Bektic; Wolfgang Horninger; Peter Lukas; Clemens Decristoforo; Paolo Castellucci; Stefano Fanti; Irene J Virgolini Journal: Eur J Nucl Med Mol Imaging Date: 2015-05-15 Impact factor: 9.236
Authors: Christian Schmidkonz; Michael Cordes; Daniela Schmidt; Tobias Bäuerle; Theresa Ida Goetz; Michael Beck; Olaf Prante; Alexander Cavallaro; Michael Uder; Bernd Wullich; Peter Goebell; Torsten Kuwert; Philipp Ritt Journal: Eur J Nucl Med Mol Imaging Date: 2018-05-03 Impact factor: 9.236