18F-choline PET/CT driven salvage radiotherapy in prostate cancer patients: up-date analysis with 5-year median follow-up
- 12 March 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in La radiologia medica
- Vol. 125 (7), 668-673
- https://doi.org/10.1007/s11547-020-01167-1
Abstract
Purpose Salvage radiotherapy is generally considered as the standard treatment for biochemical relapse after surgery. Best results have been obtained with a PSA value < 0.5 ng/ml at relapse, while 60–66 Gy is deemed as standard total dose. Modern imaging, as dynamic-18F-choline PET/CT may identify site of recurrence, allowing dose escalation to a biological target volume. Methods Hundred and fifty patients showed a local relapse at dynamic-18F-choline PET/CT at time of biochemical recurrence. High-dose salvage radiotherapy was delivered up to total dose of 80 Gy to 18F-choline PET/CT positive area. Toxicity and relapse-free survival were recorded. Results Median PSA value at the beginning of salvage radiotherapy was 0.47 ng/ml (range 0.2–17.5 ng/ml). One-hundred and thirty nine patients (93%) completed salvage radiotherapy without interruptions. Acute gastrointestinal grade ≥ 2 toxicity was recorded in 13 patients (9%), acute genitourinary grade ≥ 2 toxicity in 2 patients (1.4%). One patient (0.7%) experienced late gastrointestinal grade 4 toxicity and 2 patients (1.4%) late acute genitourinary grade 3 toxicity. With a median follow-up of 63.5 months, 5 and 7-years relapse-free survival were 70% and 60.7%, respectively. Conclusion With a median follow-up of 5 years the present study confirms that high-dose salvage radiotherapy to a biological target volume is feasible, with low rate of late toxicity and promising activity.Keywords
This publication has 25 references indexed in Scilit:
- Long-Term Outcomes After High-Dose Postprostatectomy Salvage Radiation TreatmentInternational Journal of Radiation Oncology*Biology*Physics, 2012
- Can early implementation of salvage radiotherapy for prostate cancer improve the therapeutic ratio? A systematic review and regression meta-analysis with radiobiological modellingEuropean Journal of Cancer, 2012
- The Role of Choline Positron Emission Tomography/Computed Tomography in the Management of Patients with Prostate-Specific Antigen Progression After Radical Treatment of Prostate CancerEuropean Urology, 2011
- Salvage Radiotherapy for Rising Prostate-Specific Antigen Levels After Radical Prostatectomy for Prostate Cancer: Dose–Response AnalysisInternational Journal of Radiation Oncology*Biology*Physics, 2010
- Development of RTOG Consensus Guidelines for the Definition of the Clinical Target Volume for Postoperative Conformal Radiation Therapy for Prostate CancerInternational Journal of Radiation Oncology*Biology*Physics, 2010
- RTOG GU Radiation Oncology Specialists Reach Consensus on Pelvic Lymph Node Volumes for High-Risk Prostate CancerInternational Journal of Radiation Oncology*Biology*Physics, 2009
- Radiotherapy After Prostatectomy: Is the Evidence for Dose Escalation out There?International Journal of Radiation Oncology*Biology*Physics, 2008
- Long-Term Outcome Following Radical Prostatectomy in Men With Clinical Stage T3 Prostate CancerJournal of Urology, 2006
- DEFINING PROSTATE SPECIFIC ANTIGEN PROGRESSION AFTER RADICAL PROSTATECTOMY: WHAT IS THE MOST APPROPRIATE CUT POINT?Journal of Urology, 2001
- Natural History of Progression After PSA Elevation Following Radical ProstatectomyJAMA, 1999