Paola Caroli1, Sarah Pia Colangione2, Ugo De Giorgi3, Giulia Ghigi2, Monica Celli1, Emanuela Scarpi4, Manuela Monti4, Valentina Di Iorio5, Anna Sarnelli6, Giovanni Paganelli1, Federica Matteucci1, Antonino Romeo2. 1. Unit of Nuclear Medicine, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy. 2. Department of Radiotherapy, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy. 3. Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy. 4. Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori (IRST) IRCCS, Via Maroncelli 40, 47014 Meldola, Italy. 5. Oncology Pharmacy, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy. 6. Unit of Medical Physics, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy.
Abstract
(1) Purpose: To investigate the role of 68Ga-PSMA-11 PET/CT in guiding retreatment stereotactic body radiation therapy (SBRT) in prostate cancer (PCa) patients in biochemical recurrence (BCR) after salvage radiotherapy (S-RT). (2) Methods: We retrospectively evaluated PCa patients previously treated with S-RT on the prostate bed and with proven serum prostate antigen (PSA) failure after S-RT. In all patients (pts), 68Ga-PSMA-11 PET/CT was positive in the prostate bed only and guided retreatment SBRT. All retreatments were performed by applying the same radiotherapy protocol (median dose of 18 Gy/3 fractions; IQR 18-21 Gy). The median follow-up was 27 months (range 4-35 months). (3) Results: 38 consecutive patients were considered in this analysis. The overall median PSA level before RT was 1.10 ng/mL (IQR 0.82-2.59). PSA decreased at 3 and 6 months after treatment, with a median value of 0.60 ng/mL (IQR 0.31-0.96; p < 0.001) and 0.51 ng/mL (IQR 0.29-1.17; p < 0.001), respectively. Overall, biochemical recurrence-free survival (b-RFS) was 15.0 months (95% CI 13-23). Grade-1 toxicity was reported in 31.6% of patients (12/38). (4) Conclusion: These results confirm that 68Ga-PSMA-11-PET/CT is able to identify the site of recurrence in patients who have failed S-RT, thus supporting the use of metastases-directed radiotherapy as a safe and effective treatment.
(1) Purpose: To investigate the role of 68Ga-PSMA-11 PET/CT in guiding retreatment stereotactic body radiation therapy (SBRT) in prostate cancer (PCa) patients in biochemical recurrence (BCR) after salvage radiotherapy (S-RT). (2) Methods: We retrospectively evaluated PCa patients previously treated with S-RT on the prostate bed and with proven serum prostate antigen (PSA) failure after S-RT. In all patients (pts), 68Ga-PSMA-11 PET/CT was positive in the prostate bed only and guided retreatment SBRT. All retreatments were performed by applying the same radiotherapy protocol (median dose of 18 Gy/3 fractions; IQR 18-21 Gy). The median follow-up was 27 months (range 4-35 months). (3) Results: 38 consecutive patients were considered in this analysis. The overall median PSA level before RT was 1.10 ng/mL (IQR 0.82-2.59). PSA decreased at 3 and 6 months after treatment, with a median value of 0.60 ng/mL (IQR 0.31-0.96; p < 0.001) and 0.51 ng/mL (IQR 0.29-1.17; p < 0.001), respectively. Overall, biochemical recurrence-free survival (b-RFS) was 15.0 months (95% CI 13-23). Grade-1 toxicity was reported in 31.6% of patients (12/38). (4) Conclusion: These results confirm that 68Ga-PSMA-11-PET/CT is able to identify the site of recurrence in patients who have failed S-RT, thus supporting the use of metastases-directed radiotherapy as a safe and effective treatment.
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