%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.