OBJECTIVE: The aim of this study was to report the first cases of salvage radiotherapy (RT) using the intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) targeted on choline positron emission tomography (PET) uptake in a local recurrent prostate cancer, after a radical prostatectomy. METHODS: Four patients received salvage irradiation for biochemical relapse that occurred after the initial radical prostatectomy. The relapse occurred from 10 months to 6 years with PSA levels ranging from 2.35 to 4.86 ng ml(-1). For each patient, an (18)F-choline PET-CT showed a focal choline uptake in prostatic fossa, with standardized uptake value calculated on the basis of predicted lean body mass (SUL) max of 3.3-6.8. No involved lymph node or distant metastases were diagnosed. IMRT doses were of 62.7 Gy (1.9 Gy/fraction, 33 fractions), with a SIB of 69.3 Gy (2.1 Gy/fraction, 33 fractions) to a PET-guided target volume. RESULTS: Acute toxicities were limited. We observed no gastrointestinal toxicity ≥grade 2 and only one grade 2 genitourinary toxicity. At 1-month follow-up evaluation, no complication and a decrease in PSA level (6.8-43.8% of the pre-therapeutic level) were reported. After 4 months, a decrease in PSA level was obtained for all the patients, ranging from 30% to 70%. At a median follow-up of 15 months, PSA level was controlled for all the patients, but one of them experienced a distant lymph node recurrence. CONCLUSION: Salvage irradiation to the prostate bed with SIB guided by PET-CT is feasible, with biological efficacy and no major acute toxicity. ADVANCES IN KNOWLEDGE: IMRT with PET-oriented SIB for salvage treatment of prostate cancer is possible, without major acute toxicity.
OBJECTIVE: The aim of this study was to report the first cases of salvage radiotherapy (RT) using the intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) targeted on choline positron emission tomography (PET) uptake in a local recurrent prostate cancer, after a radical prostatectomy. METHODS: Four patients received salvage irradiation for biochemical relapse that occurred after the initial radical prostatectomy. The relapse occurred from 10 months to 6 years with PSA levels ranging from 2.35 to 4.86 ng ml(-1). For each patient, an (18)F-choline PET-CT showed a focal choline uptake in prostatic fossa, with standardized uptake value calculated on the basis of predicted lean body mass (SUL) max of 3.3-6.8. No involved lymph node or distant metastases were diagnosed. IMRT doses were of 62.7 Gy (1.9 Gy/fraction, 33 fractions), with a SIB of 69.3 Gy (2.1 Gy/fraction, 33 fractions) to a PET-guided target volume. RESULTS: Acute toxicities were limited. We observed no gastrointestinal toxicity ≥grade 2 and only one grade 2 genitourinary toxicity. At 1-month follow-up evaluation, no complication and a decrease in PSA level (6.8-43.8% of the pre-therapeutic level) were reported. After 4 months, a decrease in PSA level was obtained for all the patients, ranging from 30% to 70%. At a median follow-up of 15 months, PSA level was controlled for all the patients, but one of them experienced a distant lymph node recurrence. CONCLUSION: Salvage irradiation to the prostate bed with SIB guided by PET-CT is feasible, with biological efficacy and no major acute toxicity. ADVANCES IN KNOWLEDGE: IMRT with PET-oriented SIB for salvage treatment of prostate cancer is possible, without major acute toxicity.
Authors: Shawn Malone; Jennifer Croke; Nicolas Roustan-Delatour; Eric Belanger; Leonard Avruch; Colin Malone; Christopher Morash; Cathleen Kayser; Kathryn Underhill; Yan Li; Kyle Malone; Balazs Nyiri; Johanna Spaans Journal: Int J Radiat Oncol Biol Phys Date: 2012-03-22 Impact factor: 7.038
Authors: Axel Heidenreich; Patrick J Bastian; Joaquim Bellmunt; Michel Bolla; Steven Joniau; Theodor van der Kwast; Malcolm Mason; Vsevolod Matveev; Thomas Wiegel; Filiberto Zattoni; Nicolas Mottet Journal: Eur Urol Date: 2013-11-12 Impact factor: 20.096
Authors: Hui Wang; Hansjörg Vees; Raymond Miralbell; Michael Wissmeyer; Charles Steiner; Osman Ratib; Srinivasan Senthamizhchelvan; Habib Zaidi Journal: Radiother Oncol Date: 2009-09-18 Impact factor: 6.280
Authors: Christopher R Mitchell; Val J Lowe; Laureano J Rangel; Joseph C Hung; Eugene D Kwon; R Jeffrey Karnes Journal: J Urol Date: 2012-10-30 Impact factor: 7.450
Authors: Marco M E Vogel; Sabrina Dewes; Eva K Sage; Michal Devecka; Kerstin A Eitz; Jürgen E Gschwend; Matthias Eiber; Stephanie E Combs; Kilian Schiller Journal: Front Oncol Date: 2021-07-30 Impact factor: 6.244