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68Ga-PSMA PET/CT-based metastasis-directed radiotherapy for oligometastatic prostate cancer recurrence after radical prostatectomy

  • C. ArtigasEmail author
  • P. Flamen
  • F. Charlier
  • H. Levillain
  • Z. Wimana
  • R. Diamand
  • S. Albisinni
  • T. Gil
  • R. Van Velthoven
  • A. Peltier
  • D. Van Gestel
  • T. Roumeguere
  • F.-X. Otte
Topic Paper
  • 174 Downloads

Abstract

Purpose

The aim of this communication was to assess the efficacy of directed oligometastatic radiotherapy (RT) based on 68Ga-PSMA PET/CT in patients with prostate cancer (PCa) biochemical relapse (BCR) after primary treatment with curative intent.

Methods

This is a retrospective analysis of a monocentric cohort of PCa patients diagnosed with oligometastatic disease on 68Ga-PSMA PET/CT and treated with metastasis-directed RT. Inclusion criteria were: histologically proven PCa, BCR after primary treatment with curative intent, oligometastatic disease defined as ≤ 3 metastatic lesions. To evaluate the efficacy of the therapy, biochemical response defined as a decrease of > 50% of PSA (PSA50) was measured at 1 and 4 months. Patients were followed up until progression and start of androgen deprivation therapy (ADT). BCR-free survival and ADT-free survival were calculated.

Results

20 patients met the inclusion criteria. Median PSA value: 1.4 ng/ml (IQR, 0.3–2.3 ng/ml). A total of 30 PSMA-positive lesions were treated: 18 lymph nodes (60%), nine bone (30%) and three visceral lesions (10%). Median follow-up was 15 months (range 4–33 months). Biochemical response at 1 and 4 months was found in 3/20 patients (15%) and 14/20 (70%), respectively. BCR-free survival rate at 1 year was 79% and 53% at 2 years. ADT-free survival at 2 years was 74%.

Conclusion

This retrospective study suggests that metastasis-directed RT based on 68Ga-PSMA PET/CT may be a valuable treatment in patients with PCa oligometastatic disease, providing promising BCR-free survival rates and potentially postponing ADT for at least 2 years in 74% of the patients. Response assessment should not be measured before 4 months after treatment.

Keywords

PSMA Oligometastatic Prostate cancer Radiotherapy Metastasis-directed therapy 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this retrospective study formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • C. Artigas
    • 1
    Email author
  • P. Flamen
    • 1
  • F. Charlier
    • 2
  • H. Levillain
    • 1
  • Z. Wimana
    • 1
  • R. Diamand
    • 4
  • S. Albisinni
    • 4
  • T. Gil
    • 5
  • R. Van Velthoven
    • 3
  • A. Peltier
    • 3
  • D. Van Gestel
    • 2
  • T. Roumeguere
    • 4
  • F.-X. Otte
    • 2
  1. 1.Nuclear Medicine Department, Institut Jules BordetUniversité Libre de BruxellesBrusselsBelgium
  2. 2.Radiotherapy Department, Institut Jules BordetUniversité Libre de BruxellesBrusselsBelgium
  3. 3.Urology Department, Institut Jules BordetUniversité Libre de BruxellesBrusselsBelgium
  4. 4.Urology Department, Hôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
  5. 5.Oncology Department, Institut Jules BordetUniversité Libre de BruxellesBrusselsBelgium

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