June 15, 2022 — Current guidelines used to plan salvageradiation treatmentsin patients with local recurrence ofprostate cancershould be updated to take into consideration information derived from novel imaging modalities, such asPSMA PET, according to research presented at theSociety of Nuclear Medicine and Molecular Imaging2022年度会议。该研究表明，PSMA PET对于部分或完全低于当前指南所确定的临床目标体积的复发是有效的。这表明PSMA PET可以成为治疗计划的宝贵工具。
After a biochemical recurrence of prostate cancer, salvage radiation therapy can be a curative approach. This therapy conducted following contouring guidelines based on expert consensus, such as theRadiation Therapy Oncology Group(RTOG) guidelines. In today’s era of precision medicine, study authors sought to determine if PSMA PET imaging could provide more detailed data on patterns of recurrence to inform therapy planning.
Prostate cancer patients who experienced biochemical recurrence after radical prostatectomy were included in the analysis if their PSMA PET/CT imaging showed recurrence in the prostate bed. To analyze the patterns of recurrence, two nuclear medicine physicians documented the areas of recurrence on thePSMA PET/CT, and four radiation oncologists (masked to the PSMA PET/CT findings) delineated the clinical target volume using RTOG guidelines on the CT images of the PET/CT. PSMA recurrence locations were then compared to the RTOG-based clinical target volumes.
PSMA recurrences were fully covered by the clinical target volumes in 54 percent of the patients. In 34 percent of the patients, PSMA recurrence was only partly covered, and in 13 percent of patients the PSMA recurrence was located fully outside of the clinical target volume.
“This study has the potential to redefine prostate bed contouring guidelines to improve the therapeutic ratio for patients receiving postoperative radiotherapy,” saidIda Sonni, MD, project scientist in the Department of Radiology at the University of California, Los Angeles. “Nuclear medicine andmolecular imagingadvances, such as PSMA PET, have the ability to guide individualized, tailored treatments that will ultimately benefit all our patients.”
For more information:www.snmmi.org
July 20, 2022
