Universität zu Köln

Ehret, Felix ORCID: 0000-0001-6177-1755, Hofmann, Theresa, Fuerweger, Christoph, Kufeld, Markus, Staehler, Michael, Muacevic, Alexander and Haidenberger, Alfred (2023). Single-fraction prostate-specific membrane antigen positron emission tomography- and multiparametric magnetic resonance imaging-guided stereotactic body radiotherapy for prostate cancer local recurrences. BJU Int., 131 (1). S. 101 - 109. HOBOKEN: WILEY. ISSN 1464-410X

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Abstract

Objective To analyse the efficacy and safety of focal prostate-specific membrane antigen positron emission tomography (PSMA-PET)- and multiparametric magnetic resonance imaging (mpMRI)-guided single-fraction stereotactic body radiotherapy (SBRT) for the treatment of prostate cancer (PCa) local recurrences. Patients and Methods Patients with PSMA-PET-positive PCa local recurrences treated with single-fraction SBRT between 2016 and 2020 were included. Identification for subsequent recurrences or metastatic spread based on increasing prostate-specific antigen (PSA) levels were evaluated using PSMA-PET imaging. Results A total of 64 patients were identified. Patients received various treatments before SBRT (31 patients with radical prostatectomy [RP], 18 external beam radiotherapy [EBRT] with RP, five EBRT, and the remaining 10 other combinations). The median follow-up was 21.6 months. The median PSA level before SBRT was 1.47 ng/mL. All patients received a single-fraction treatment with a median prescription dose and isodose line of 21 Gy and 65%, respectively. At the time of SBRT, six patients (9%) received an androgen deprivation therapy (ADT). PSA levels decreased after SBRT (P = 0.03) and three local recurrences were detected during the follow-up. The progression-free survival after 1-, 2-, and 3-years was 85.3%, 65.9%, and 51.2%, respectively. Six patients (9%) started ADT after SBRT due to disease progression. The rates of newly started ADT after 1-, 2-, and 3-years were 1.8%, 7.3%, and 22.7%, respectively. Grade 1 or 2 toxicities occurred in six patients (9%); no high-grade toxicity was observed. Conclusion While the available data for SBRT in the PCa local recurrence setting describe outcomes for fractionated irradiations, the findings of this first analysis of single-fraction, PSMA-PET- and mpMRI-guided focal SBRT are encouraging. Such treatment appears to be a safe, efficient, and time-saving therapy even in intensively pretreated patients. Recurrence-directed treatments can delay the use of ADT and could avoid prostate bed irradiation in selected patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ehret, Felix UNSPECIFIED orcid.org/0000-0001-6177-1755 UNSPECIFIED Hofmann, Theresa UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuerweger, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kufeld, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Staehler, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Muacevic, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Haidenberger, Alfred UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-684904
DOI:	10.1111/bju.15894
Journal or Publication Title:	BJU Int.
Volume:	131
Number:	1
Page Range:	S. 101 - 109
Date:	2023
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1464-410X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RADIATION-THERAPY Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68490