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A prospective phase...
A prospective phase II study of prostate-specific antigen-guided salvage radiotherapy and Ga-68-PSMA-PET for biochemical relapse after radical prostatectomy-The PROPER 1 trial
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- Gunnlaugsson, Adalsteinn (författare)
- Lund University,Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Systemisk strålterapi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Systemic radiation therapy,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Johannesson, Vilberg (författare)
- Lund University,Lunds universitet,Systemisk strålterapi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Systemic radiation therapy,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Wieslander, Elinore (författare)
- Lund University,Lunds universitet,Medicinsk strålningsfysik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medical Radiation Physics, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Brun, Eva (författare)
- Lund University,Lunds universitet,Huvud- och halscancergruppen,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Head and Neck Cancer Research Group,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital
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- Bitzen, Ulrika (författare)
- Lund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Ståhl, Olof (författare)
- Lund University,Lunds universitet,Medicinsk onkologi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medical oncology,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Bratt, Ola, 1963 (författare)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Sahlgrenska University Hospital
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- Ahlgren, Göran (författare)
- Perituskliniken AB
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- Ohlsson, T. (författare)
- Lund University,Skåne University Hospital
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- Kjellén, Elisabeth (författare)
- Lund University,Lunds universitet,Huvud- och halscancergruppen,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Head and Neck Cancer Research Group,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital
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- Nilsson, Per (författare)
- Lund University,Lunds universitet,Radiotherapy Physics,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- Elsevier BV, 2022
- 2022
- Engelska.
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Ingår i: Clinical and Translational Radiation Oncology. - : Elsevier BV. - 2405-6308. ; 36, s. 77-82
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- Background and purpose: The treatment of biochemical recurrence (BCR) after prostatectomy is challenging as the site of the recurrence is often undetectable. Our aim was to test a personalised treatment concept for BCR based on PSA kinetics during salvage radiotherapy (SRT) combined with prostate-specific membrane antigen positron emission tomography (PSMA-PET). Materials and methods: This phase II trial included 100 patients with BCR. PSMA-PET was performed at baseline. PSA was measured weekly during SRT. Initially, 70 Gy in 35 fractions was prescribed to the prostate bed. Radiotherapy was adapted after 50 Gy. Non-responders (PSA still >= 0.15 ng/mL) received sequential lymph node irradiation with a boost to PSMA-PET positive lesions, while responders (PSA < 0.15 ng/mL) continued SRT as planned. PET-findings were only taken into consideration for treatment planning in case of PSA non-response after 50 Gy. Results: Data from 97 patients were eligible for analysis. Thirty-four patients were classified as responders and 63 as non-responders. PSMA-PET was positive in 3 patients (9%) in the responder group and in 22 (35%) in the non-responder group (p = 0.007). The three-year failure-free survival was 94% for responders and 68% for non-responders (median follow-up 38 months). There were no significant differences in physician-reported urinary and bowel toxicity. Patient-reported diarrhoea at end of SRT was more common among non-responders. Conclusion: This new personalised treatment concept with intensified SRT based on PSA response demonstrated a high tumour control rate in both responders and non-responders. These results suggest a clinically significant effect with moderate side effects in a patient group with otherwise poor prognosis. PSMA-PET added limited value. The treatment approach is now being evaluated in a phase III trial.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
Nyckelord
- Salvage radiotherapy
- Prostate cancer
- Adaptive
- Prostate specific
- antigen
- Prostate specific membrane antigen
- ga-68-labeled psma ligand
- androgen suppression
- radiation-therapy
- diagnosis
- cancer
- pet/ct
- neoadjuvant
- update
- Oncology
- Radiology
- Nuclear Medicine & Medical Imaging
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Gunnlaugsson, Ad ...
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Johannesson, Vil ...
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Wieslander, Elin ...
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Brun, Eva
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Bitzen, Ulrika
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Ståhl, Olof
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Bratt, Ola, 1963
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Ahlgren, Göran
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Ohlsson, T.
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Kjellén, Elisabe ...
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Nilsson, Per
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