Delineating biochemical failure with 68Ga-PSMA-PET following definitive external beam radiation treatment for prostate cancer
| Autor: | Julia Hunter, Ed Hsiao, Louise Emmett, Geoff Schembri, George Hruby, Andrew Kneebone, Thomas Eade, Lesley Guo, Carol Kwong, Bao Ho |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry Distant disease Biochemical failure External beam radiation Urology 68ga psma Hematology urologic and male genital diseases medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer 0302 clinical medicine medicine.anatomical_structure Oncology Prostate 030220 oncology & carcinogenesis medicine Radiology Nuclear Medicine and imaging Lost to follow-up business Nuclear medicine Lymph node |
| Zdroj: | Radiotherapy and Oncology. 122:99-102 |
| ISSN: | 0167-8140 |
| Popis: | Background and purpose We investigated the role of 68 Ga-PSMA-PET (PSMA) to determine the location of disease recurrence in those with a rising PSA following definitive external beam radiation treatment (EBRT). Materials and methods 538men were treated with image guided EBRT to a dose of 78 or 82Gy between 2007 and 2014. Patients at least 24months post EBRT with biochemical failure (nadir+2) underwent PSMA scanning. Local recurrence (LR) was defined as increased uptake within the prostate or seminal vesicles. Distant disease included lymph node (LN), bone or visceral metastases. Results 419men formed the study cohort. Median follow-up was 50months, 70 patients (17%) had biochemical failure (BF), 13 of whom have died. Of the 57 survivors, 5 had metastases detected on conventional scans; 2 were lost to follow up. 48men (of 50 candidates) underwent PSMA; in all cases, the PSMA was unequivocally positive. Of the 48 positive scans, 25 patients (52%) failed beyond the prostate – 5 in bones, 16LN, 3 in both, and 1 in the lungs. Fifteen men (31%) failed within the gland and in either LN (11), bones (3), or both (1). Eight (17%) had an isolated LR, which represents 2% of patients managed with definitive EBRT and followed for at least 2years. Conclusions PSMA was positive in all patients with BF. Site of failure following dose-escalated EBRT was generally distant. Isolated LR (on PSMA) occurred in only 8 of 419 patients post-EBRT. |
| Databáze: | OpenAIRE |
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