%A Vogel,Marco M. E.
%A Dewes,Sabrina
%A Sage,Eva K.
%A Devecka,Michal
%A Eitz,Kerstin A.
%A Gschwend,Jürgen E.
%A Eiber,Matthias
%A Combs,Stephanie E.
%A Schiller,Kilian
%D 2021
%J Frontiers in Oncology
%C
%F
%G English
%K SIB,relapse,positron emission tomography,prostate-specific membrane antigen,side effects,Disease-Free Survival
%Q
%R 10.3389/fonc.2021.715020
%W
%L
%M
%P
%7
%8 2021-July-30
%9 Original Research
%+ Marco M. E. Vogel,Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM),Germany,marco.vogel@tum.de
%+ Marco M. E. Vogel,Institute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München,Germany,marco.vogel@tum.de
%#
%! PSMA-PET-based Dose-Escalated Salvage Radiotherapy
%*
%<
%T Feasibility and Outcome of PSMA-PET-Based Dose-Escalated Salvage Radiotherapy Versus Conventional Salvage Radiotherapy for Patients With Recurrent Prostate Cancer
%U https://www.frontiersin.org/articles/10.3389/fonc.2021.715020
%V 11
%0 JOURNAL ARTICLE
%@ 2234-943X
%X IntroductionProstate-specific membrane antigen-positron emission tomography-(PSMA-PET) imaging facilitates dose-escalated salvage radiotherapy (DE-SRT) with simultaneous-integrated boost (SIB) for PET-positive lesions in patients with prostate cancer (PC). Therefore, we aimed to compare toxicity rates of DE-SRT with SIB to conventional SRT (C-SRT) without SIB and to report outcome.Materials and MethodsWe evaluated 199 patients who were treated with SRT between June 2014 and June 2020. 101 patients received DE-SRT with SIB for PET-positive local recurrence and/or PET-positive lymph nodes. 98 patients were treated with C-SRT to the prostate bed +/− elective pelvic lymphatic pathways without SIB. All patients received PSMA-PET imaging prior to DE-SRT ([68Ga]PSMA-11: 45.5%; [18F]-labeled PSMA: 54.5%). Toxicity rates for early (<6 months) and late (>6 months) gastrointestinal (GI) toxicities rectal bleeding, proctitis, stool incontinence, and genitourinary (GU) toxicities hematuria, cystitis, urine incontinence, urinary obstruction, and erectile dysfunction were assessed. Further, we analyzed the outcome with disease-free survival (DFS) and prostate-specific antigen (PSA) response.ResultsThe overall toxicity rates for early GI (C-SRT: 2.1%, DE-SRT: 1.0%) and late GI (C-SRT: 1.4%, DE-SRT: 5.3%) toxicities ≥ grade 2 were similar. Early GU (C-SRT: 2.1%, DE-SRT: 3.0%) and late GU (C-SRT: 11.0%, DE-SRT: 14.7%) toxicities ≥ grade 2 were comparable, as well. Early and late toxicity rates did not differ significantly between DE-SRT versus C-SRT in all subcategories (p>0.05). PSA response (PSA ≤0.2 ng/ml) in the overall group of patients with DE-SRT was 75.0% and 86.4% at first and last follow-up, respectively.ConclusionDE-SRT showed no significantly increased toxicity rates compared with C-SRT and thus is feasible. The outcome of DE-SRT showed good results. Therefore, DE-SRT with a PSMA-PET-based SIB can be considered for the personalized treatment in patients with recurrent PC.