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. 2023 Sep;83(13):1298-1305.
doi: 10.1002/pros.24592. Epub 2023 Jul 2.

PSMA PET-based stereotactic body radiotherapy for locally recurrent prostate cancer after definitive first-line therapy

Arne Gruen  1 , Katharina Tegel  2 , Anne Kluge  3 , Volker Budach  4 , Daniel Zips  5 , Dirk Boehmer  6
Affiliations

PSMA PET-based stereotactic body radiotherapy for locally recurrent prostate cancer after definitive first-line therapy

Arne Gruen et al. Prostate. 2023 Sep.

Abstract

Background: Advances in prostate-specific membrane antigen (PSMA) PET-computed tomography (CT) and magnetic resonance imaging (MRI) allow the detection and localization of exclusively local prostate-cancer-recurrences after definitive first-line therapy. PSMA-based early detection of circumscribed local recurrences followed by hypofractionated high-precision stereotactic body radiotherapy (SBRT) might yield long-term disease control at moderate rates of adverse effects.

Methods: Retrospective analysis of 35 patients treated for locally recurrent prostate cancer between November 2012 and December 2021 with PSMA PET- and MRI-based robotic SBRT.

Results: Thirty-five patients treated with local prostate cancer recurrence post surgery, post surgery, and adjuvant/salvage radiotherapy (RT) and after definitive RT. All but one patients had fractionated SBRT in 3-5 fractions. Median progression-free survival (PFS) was 52.2 months for all patients and 52.2 months in the radical prostatectomy (RPE) group, 31.2 months in the RPE + RT group and not reached in the RT group. The most common event was increased urinary frequency grade 1-2. 54.3% of all patients had no acute and 79.4% no late toxicity during follow-up.

Discussion: Our PFS of 52.2 months (RPE), 31.2 months (RPE + RT) and not reached (RT) compares favorably with published data. This method constitutes a valid alternative to morbidity-prone invasive approaches or palliative systemic therapy.

Keywords: prostate cancer; recurrence; salvage radiotherapy.

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References

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