Toxicity and efficacy of salvage carbon 11-choline positron emission tomography/computed tomography-guided radiation therapy in patients with lymph node recurrence of prostate cancer
Autor: | Italo Dell'Oca, Elena Busnardo, Paola Mangili, Margarita Kirienko, Luigi Gianolli, Andrei Fodor, Claudio Fiorino, Elena Incerti, Cesare Cozzarini, Marcella Pasetti, Riccardo Calandrino, Maria Picchio, Nadia Di Muzio, G. Berardi |
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Přispěvatelé: | Fodor, Andrei, Berardi, Genoveffa, Fiorino, Claudio, Picchio, Maria, Busnardo, Elena, Kirienko, Margarita, Incerti, Elena, Dell'Oca, Italo, Cozzarini, Cesare, Mangili, Paola, Pasetti, Marcella, Calandrino, Riccardo, Gianolli, Luigi, Di Muzio, Nadia G |
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Biochemical recurrence
Male medicine.medical_specialty medicine.medical_treatment Urology salvage radiation therapy Multimodal Imaging Tomotherapy 030218 nuclear medicine & medical imaging Choline 03 medical and health sciences Prostate cancer 0302 clinical medicine Retrospective Studie Positron Emission Tomography Computed Tomography medicine Humans Lymph node Retrospective Studies Aged Aged 80 and over Salvage Therapy 11C- Choline PET/CT Genitourinary system business.industry Hazard ratio Prostatic Neoplasms lymph node recurrence Lymphatic Metastasi Middle Aged medicine.disease prostate cancer Radiation therapy medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Lymphatic Metastasis Toxicity Prostatic Neoplasm Radiology Radiotherapy Intensity-Modulated Neoplasm Recurrence Local business Nuclear medicine Human Radiotherapy Image-Guided |
Popis: | Objective: To report the 3-year toxicity and outcomes of carbon 11 (11C)-choline-positron emission tomography (PET)/computed tomography (CT)-guided radiotherapy (RT), delivered via helical tomotherapy (HTT; Tomotherapy® Hi-Art II® Treatment System, Accuray Inc., Sunnyvale, CA, USA) after lymph node (LN) relapses in patients with prostate cancer. Patients and Methods: From January 2005 to March 2013, 81 patients with biochemical recurrence after surgery, with or without adjuvant/salvage RT or radical RT, and with evidence of LN 11C-choline-PET/CT pathological uptake, underwent HTT (median [range] prostate-specific antigen level 2.59 [0.61â187] ng/mL). Of the 81 patients, 72 were treated at the pelvic and/or lumbar-aortic LN chain with HTT at 51.8 Gy/28 fr and with simultaneous integrated boost to a median dose of 65.5 Gy on the pathological uptake sites detected by 11C-choline-PET/CT. Nine patients were treated without simultaneous integrated boost (50â65.5 Gy, 25â30 fr). Results: With a median (range) follow-up of 36 (9â116) months, 91.4% of the patients had a PSA reduction 3 months after HTT. The 3-year overall, local relapse-free and clinical relapse-free survival rates were 80.0, 89.8 and 61.8%, respectively. The 3-year actuarial incidences of â¥grade 2 rectal and â¥grade 2 genitourinary toxicity were 6.6% (±2.9%) and 26.3% (±5.5%), respectively. A PSA nadir of â¥0.26 ng/mL (hazard ratio [HR] 3.6, 95% confidence interval [CI] 1.7â7.7; P = 0.001), extrapelvic 11C-choline-PET/CT-positive LN location (HR 2.4, 95% CI 0.9â6.4; P = 0.07), RT previous to HTT (HR 2.7; 95% CI 1.07â6.9, P = 0.04) and number of positive LNs (HR 1.13, 95% CI 1.04â1.22; P = 0.003) were the main predictors of clinical relapse after HTT. Conclusions: 11C-choline-PET/CT-guided HTT is safe and effective in the treatment of LN relapses of prostate cancer in previously treated patients. |
Databáze: | OpenAIRE |
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