Can PSMA PET/CT help in dose-tailoring in post-prostatectomy radiotherapy?

Frontiers in Oncology

Oncology

Irene A. Burger¹  Stephanie G. C. Kroeze²  Christoph Oehler³  Daniel Rudolf Zwhalen³  Ambroise Champion⁴  David Benzaquen⁴  Daniel Taussky⁵ 

[1] Department of Nuclear Medicine, Kantonsspital Baden, Baden, Switzerland;Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Zurich, Switzerland;Department of Radiation Oncology Kantonsspital Aarau and Baden, Kantonsspital Aarau, Aarau, Switzerland;Department of Radiation Oncology, Kantonsspital Winterthur, Winterthur, Switzerland;Radiation Oncology, Hôpital de La Tour, Meyrin, Switzerland;Radiation Oncology, Hôpital de La Tour, Meyrin, Switzerland;Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada;

关键词: prostate cancer;    postoperative radiotherapy;    PSMA-PET;    PSA;    dose ecalation;   

DOI  :  10.3389/fonc.2023.1268309

 received in 2023-07-27, accepted in 2023-09-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

There are few randomized trials to evaluate the use of PSMA-PET in the planning of post-prostatectomy radiotherapy. There are two unresolved questions 1) should we increase the dose to lesions visible on PSMA-PET 2) can we reduce dose in the case of a negative PSMA-PET. In this review, we summarize and discuss the available evidence in the literature. We found that in general, there seems to be an advantage for dose-increase, but ta large recent study from the pre-PSMA era didn’t show an advantage for dose escalation. Retrospective studies have shown that conventional doses to PSMA-PET-positive lesions seem sufficient. On the other hand, in the case of a negative PSMA-PET, there is no evidence that dose-reduction is possible. In the future, the combination of PSMA-PET with genomic classifiers could help in better identify patients who might benefit from either dose- de-or -increase. We further need to identify intraindividual references to help identify lesions with higher aggressiveness.

【 授权许可】

Unknown   
Copyright © 2023 Champion, Zwhalen, Oehler, Taussky, Kroeze, Burger and Benzaquen