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Efficacy of PSMA PET-Guided Radiotherapy for Oligometastatic Castrate-Resistant Prostate Cancer

Christoph Henkenberens, Thorsten Derlin, Frank Bengel, Tobias L. Ross, Markus A. Kuczyk, Frank A. Giordano, Gustavo R. Sarria, Leonard Christopher Schmeel, Hans Christiansen, Christoph A. J. von Klot
2021 Frontiers in Oncology  
Copyright © 2021 Henkenberens, Derlin, Bengel, Ross, Kuczyk, Giordano, Sarria, Schmeel, Christiansen and von Klot.  ... 
doi:10.3389/fonc.2021.664225 pmid:33954116 pmcid:PMC8089391 fatcat:vyquqlr3rjcvplia6quyobqvim

Applicability of readout-segmented echoplanar diffusion weighted imaging for prostate MRI

Susanne Hellms, Marcel Gutberlet, Matti Joonas Peperhove, Stefanie Pertschy, Christoph Henkenberens, Inga Peters, Frank Wacker, Katja Derlin
2019 Medicine  
To evaluate readout-segmented echoplanar (rsEPI) diffusion weighted imaging (DWI) for multiparametric (mp) magnetic resonance imaging (MRI) of the prostate compared to the established single-shot echoplanar imaging (ssEPI) sequence.One hundred ten consecutive patients with clinical suspicion of prostate cancer underwent mp prostate MRI using both, the ssEPI and the rsEPI DWI sequence. For an objective assessment, delineation of the prostate shape on both DWI sequences was compared to
more » ... images by measuring organ diameters. Apparent diffusion coefficient (ADC) values, image contrast and contrast-to-noise ratio (CNR) were compared between the 2 sequences on a region-of-interest-based analysis. Diagnostic accuracy for quantitative ADC-values was calculated. Histopathology from MRI/ultrasound fusion-guided biopsy was used as reference standard. For a subjective assessment, 2 independent readers visually assessed image quality of both sequences using Likert-scales.Delineation of the prostate shape was more accurate with rsEPI compared to ssEPI. ADC values in target lesions were not significantly different but significantly higher in the surrounding normal prostatic tissue of the transition zone. CNR was comparable between ssEPI and rsEPI. Sensitivity and specificity were good for both sequences with 84/84% and 82/73% with a Youden selected cut-off of ADC = 0.971*10 mm/s for rsEPI and 1.017*10 mm/s for ssEPI. Anatomic artifacts were significantly less and SNR was lower on rsEPI compared to ssEPI in the subjective analysis.Delineation of the prostate shape was more accurate with rsEPI DWI than with ssEPI DWI with less anatomic artifacts and higher subjective SNR and image quality on rsEPI DW images. Diagnostic ability of quantitative ADC-values was not significantly different between the 2 sequences. Thus, rsEPI DWI might be more suitable for prostate MRI with regard to MRI-guided targeted biopsy and therapy planning.
doi:10.1097/md.0000000000016447 pmid:31335699 pmcid:PMC6709253 fatcat:vjvbzz4ywjftti4ob43yf32oni

Efficacy of repeated PSMA PET-directed radiotherapy for oligorecurrent prostate cancer after initial curative therapy

Christoph Henkenberens, Ann-Kathrin Oehus, Thorsten Derlin, Frank Bengel, Tobias L. Ross, Markus A. Kuczyk, Stefan Janssen, Hans Christiansen, Christoph A. J. von Klot
2020 Strahlentherapie und Onkologie (Print)  
Henkenberens, A.-K. Oehus, T. Derlin, F. Bengel, T.L. Ross, M.A. Kuczyk, S. Janssen, H. Christiansen, and C.A.J. von Klot declare that they have no competing interests.  ... 
doi:10.1007/s00066-020-01629-5 pmid:32399639 fatcat:pfdq5bcaeve4lpfqbg43zdmoje

Non-Attendance to Post-Radiotherapy Follow-Up in Breast Cancer: Efficacy of Mail and Telephone Reminders

Frank Bruns, Frank Bruns, Anne Caroline Knöchelmann, Christoph Henkenberens, Hans Christiansen
2020 Clinical Oncology and Research  
To assess the efficacy of two reminder interventions in improving post-radiotherapy followup attendance rates of breast cancer patients. Methods: Three periods of three months were assessed, a baseline period, an intervention period and a confirmation period. In the intervention period, a two-step reminder system was used. This system consisted of a mail reminder (IV1) that was sent to all patients three to four weeks prior to the post-radiotherapy follow-up visit, which was followed by up to
more » ... o telephone calls (IV2) for all patients who did not attend this follow-up visit. During the confirmation period, IV2 was used exclusively to assess the maximal possible efficacy of the telephone reminder. Results: The non-attendance rate of breast cancer patients was 18.1% (19/105) in the baseline period; this rate decreased to 13.1% in the intervention period (23/176; p=0.33) after IV1 and then decreased to 6.3% (11/176; p=0.03) after IV2. In the confirmation period, 24.4% (42/172) of breast cancer patients did not attend their post-radiotherapy follow-up visit; the non-attendance rate decreased significantly after (exclusive) IV2 from 24.4% (42/172) to 9.3% (16/172; p<0.001). Significance was observed for the first call but not for the second call in the chi-square test. Conclusion: Telephone reminder is an effective tool for improving breast cancer patient adherence to the post-radiotherapy follow-up visit. In this study, the telephone reminder system was more effective than the mail reminder system.
doi:10.31487/j.cor.2020.08.03 fatcat:5ov3cjn6w5ebxjcgc526gvxeum

Comorbidity indexing for prediction of the clinical outcome after stereotactic body radiation therapy in non-small cell lung cancer

Julia Dreyer, Michael Bremer, Christoph Henkenberens
2018 Radiation Oncology  
Purpose: To determine the prognostic impact of comorbidity and age in medically inoperable early-stage nonsmall cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT) using the age-adjusted Charlson Comorbidity Index (aCCI). Patients and methods: Between November 2008 and January 2015, 196 consecutive patients with medically inoperable NSCLC were treated with SBRT at a single institution. The prescribed isocenter dose was either 60.0 Gray (Gy) in six fractions for central
more » ... ng cancer or 56.25 Gy in three fractions for peripheral lung cancer. Baseline comorbidities were retrospectively retrieved according to available outclinic medical records as well as the hospital information system. The aCCI was scored for each patient and subjected according to outcome and toxicity as well as all of the single items of the aCCI and other clinical parameters using univariate and multivariate analysis. Results: Thirty-one point 6 % (62/196) of patients were deceased, of whom 17.3% (34/196) died due to lung cancer and 14.3% (28/196) due to comorbidities. The median overall survival (OS) was 15.0 months (95% CI [11.9-18.1]), whereas the median cancer-specific survival (CSS) was not reached. An aCCI ≥7 compared with an aCCI ≤6 was significantly associated with an increased risk of death (HR 1.79, 95% CI [1.02-2.80], p = 0.04) and cancer-specific death (HR 9.26,.39], p < 0.001), respectively. Neither OS nor CCS were significantly associated with age, sex, side (left vs. right), lobe, localization (central vs. peripheral), packyears, TNM, or any item of the aCCI. Considering the 14.3% (28/196) of deceased patients who died due to comorbidities, aCCI ≥9 was significantly associated with non-cancer-related death (HR 3.12,], p = 0.02). The observed cumulative rate of radiation pneumonitis (RP) ≥2 was 12.7% (25/196). The aCCI had no statistical association with RP. Conclusion: Advanced age and numerous comorbidities characterizing this patient population were successfully assessed using the aCCI in terms of survival. Therefore, we recommend that age and comorbidity be indexed using the aCCI as a simple scoring system for all patients treated with SBRT for lung cancer.
doi:10.1186/s13014-018-1156-1 fatcat:lwp7fmkrajf7rco4pv4lvco5ye

Temporal and spatial dose distribution of radiation pneumonitis after concurrent radiochemotherapy in stage III non-small cell cancer patients

Mohammed Alharbi, Stefan Janssen, Heiko Golpon, Michael Bremer, Christoph Henkenberens
2017 Radiation Oncology  
and purpose: Radiation pneumonitis (RP) is the most common subacute side effect after concurrent chemoradiotherapy (CRT) for locally advanced non-small cell lung cancer. Several clinical and dose-volume (DV) parameters are associated with a distinct risk of symptomatic RP. The aim of this study was to assess the spatial dose distribution of the RP volume from first occurence to maximum volume expansion of RP. Material and methods: Between 2007 and 2015, 732 patients with lung cancer were
more » ... in an institution. Thirty-three patients met the following inclusion criteria: an RP grade II after CRT and a radiation dose ≥60 Gy and no prior medical history of cardiopulmonary comorbidities. The images of the first chest computed tomography (CT) confirming the diagnosis of RP and the CT images showing the maximum expansion of RP were merged with the treatment plan. The RP volume was delineated within the treatment plan, and a DV analysis was performed to evaluate the lung dose volume areas in which the RP manifested over time and whether dose volume changes within the RP volume occurred. Results: A change from clinical diagnosis to maximum expansion of RP was observed as the RP at clinical appearance mainly manifested in the lower dose areas of the lung, whereas the RP volume at maximum expansion manifested in the higher dose areas, resulting in a significant shift of the assessed relative mean dose volume proportions within the RP volume. The mean relative dose volume proportion 0-≤ 20 Gy decreased from 30.2% (range, 0-100) to 21.9% (range, 0-100; p = 0.04) at the expense of the dose volume > 40 Gy which increased from 39.2% (range, 0-100) to 49. 8% (range, 0-100; p = 0.02), whereas the dose relative volume proportion > 20-≤ 40 Gy showed no relevant change and slightly decreased from 30.6% (range, 0-85.7) to 28.3%, (range, 0-85.7; p = 0.34). Conclusion: We observed a considerable increase in the relative dose proportions within the RP volume from diagnosis to maximum volume extent from low dose zones below 20 Gy to zones above 40 Gy. Although the clinical impact on RP remains unknown, a reduction of healthy healthy lung tissue receiving >40 Gy (V40) might be an additional parameter for irradiation planning in lung cancer patients.
doi:10.1186/s13014-017-0898-5 pmid:29096667 pmcid:PMC5667443 fatcat:rnxcp6c7djgtfdkvsepazskdxe

Frequency and risk factors for arm lymphedema after multimodal breast-conserving treatment of nodal positive breast Cancer – a long-term observation

Julia Rupp, Catarina Hadamitzky, Christoph Henkenberens, Hans Christiansen, Diana Steinmann, Frank Bruns
2019 Radiation Oncology  
Arm-lymphedema is a major complication after breast cancer. Recent studies demonstrate the validity of predicting Breast Cancer Related Lymphedema (BCRL) by self-reports. We aimed to investigate the rate of BCRL and its risk factors in the long-term using self-reported symptoms. Methods: Data was collected from 385 patients who underwent multimodal therapy for nodal positive breast cancer, including breast conserving surgery, axillary dissection, and local or locoregional radiotherapy. Two
more » ... ated questionnaires were used for the survey of BCRL (i.e. LBCQ-D and SDBC-D). These were analysed collectively with retrospective data of our medical records. Results: 23.5% (n = 43) suffered a permanent BCRL (stage II-III) after a median follow-up time of 10.1 years (4.9-15.9 years); further 11.5% (n = 23) reported at least one episode of reversible BCRL (Stage 0-I) during the follow-up time. 87.1% of the patients with lymphedema developed this condition in the first two years. Adjuvant chemotherapy was a significant risk factor for the appearance of BCRL (p = 0.001; 95%-CI 7.7-10.2). Conclusions: Breast cancer survivors face a high risk of BCRL, particularly if axillary dissection was carried out. Almost 90% of BCRL occurred during the first two years after radiotherapy. Self-report of symptoms seems to be a suitable instrument of early detection of BCRL.
doi:10.1186/s13014-019-1243-y fatcat:nxa2z5rfnved5bysuyoednar5e

Neuroendocrine Differentiation and Response to PSMA-Targeted Radioligand Therapy in Advanced Metastatic Castration-Resistant Prostate Cancer: a Single-Center Retrospective Study

Thorsten Derlin, Rudolf A. Werner, Marcel Lafos, Christoph Henkenberens, Christoph A. J. von Klot, Jan Sommerlath Sohns, Tobias L. Ross, Frank M. Bengel
2020 Journal of Nuclear Medicine  
Neuroendocrine differentiation is associated with treatment failure and poor outcome in metastatic castration-resistant prostate cancer (mCRPC). We investigated the effect of circulating neuroendocrine biomarkers on the efficacy of PSMA-targeted radioligand therapy (RLT). Methods: Neuroendocrine biomarker profiles (progastrin-releasing peptide, neuron-specific enolase, and chromogranin-A) were analyzed in 50 patients commencing 177Lu-PSMA-617 RLT. The primary endpoint was PSA response in
more » ... n to baseline neuroendocrine marker profiles. Additional endpoints included progression-free survival. Tumor uptake on post-therapeutic scans, a known predictive marker for response, was used as control-variable. Results: Neuroendocrine biomarker profiles were abnormal in the majority of patients. Neuroendocrine biomarker levels did not predict treatment failure or early progression (P ≥ 0.13). By contrast, intense PSMA-ligand uptake in metastases predicted both treatment response (P = 0.0030) and reduced risk of early progression (P = 0.0111). Conclusion: Neuroendocrine marker profiles do not predict adverse outcome of RLT. By contrast, high ligand uptake was confirmed to be crucial for achieving tumor-response.
doi:10.2967/jnumed.120.241588 pmid:32169910 fatcat:rgcfukqp4rbyjhgzv4sdtpeyqe

Predictive and Prognostic Impact of Blood-Based Inflammatory Biomarkers in Patients with Gastroenteropancreatic Neuroendocrine Tumors Commencing Peptide Receptor Radionuclide Therapy

Fiona Ohlendorf, Rudolf Werner, Christoph Henkenberens, Tobias Ross, Hans Christiansen, Frank Bengel, Thorsten Derlin
2021 Diagnostics  
Tumor microenvironment inflammation contributes to the proliferation and survival of malignant cells, angiogenesis, metastasis, subversion of adaptive immunity, and reduced treatment response. We aimed to evaluate the early predictive and prognostic significance of markers of systemic inflammation in patients receiving somatostatin-receptor targeted peptide receptor radionuclide therapy (PRRT). This retrospective observational cohort study included 33 patients with advanced
more » ... tic neuroendocrine tumors (GEP-NETs) treated with PRRT. Pretreatment blood-based inflammatory biomarkers, e.g., Creactive protein levels (CRP), white blood cell count (WBC), and absolute neutrophil count (ANC), were documented and inflammation indexes, e.g., neutrophil-lymphocyte ratio (NLR) and Platelet × CRP multiplier (PCM), were calculated. Tumor burden was determined using [68Ga]GaDOTATATE PET/CT before enrollment and every 2 cycles thereafter until progression. Therapy response was assessed using RECIST 1.1, including its volumetric modification. Inflammatory biomarkers and inflammatory indexes demonstrated marked heterogeneity among patients, and were significantly higher in non-responders (e.g., CRP (P < 0.001), ANC (P = 0.002), and PCM (P < 0.001)). Change in whole-body tumor burden after two cycles of PRRT was significantly associated with CRP (P = 0.0157) and NLR (P = 0.0040) in multivariate regression analysis. A cut-off of 2.5 mg/L for CRP (AUC = 0.84, P = 0.001) revealed a significant outcome difference between patients with adversely high vs. low CRP (median PFS 508 days vs. not yet reached (HR = 4.52; 95% CI, 1.27 to 16.18; P = 0.02)). Tumor-driven systemic inflammatory networks may be associated with treatment response, change in tumor burden, and prognosis in patients with GEPNETs receiving PRRT.
doi:10.3390/diagnostics11030504 pmid:33809226 pmcid:PMC8000284 fatcat:3oekwmgasrb3jjsbhc3ebnlpiq

Initial Experience with Volumetric68Ga-PSMA I&T PET/CT for Assessment of Whole-Body Tumor Burden as a Quantitative Imaging Biomarker in Patients with Prostate Cancer

Sebastian Schmuck, Christoph A. von Klot, Christoph Henkenberens, Jan M. Sohns, Hans Christiansen, Hans-Jürgen Wester, Tobias L. Ross, Frank M. Bengel, Thorsten Derlin
2017 Journal of Nuclear Medicine  
A quantitative imaging biomarker is desirable to provide a comprehensive measure of whole-body tumor burden in patients with metastatic prostate cancer, and to standardize the evaluation of treatment-related changes. Therefore, we evaluated whether prostate-specific membrane antigen (PSMA) ligand PET/CT may be applied to provide PSMA-derived volumetric parameters for quantification of whole-body tumor burden. Methods: One hundred one patients who underwent 68 Ga-PSMA I&T PET/CT because of
more » ... sing prostate-specific antigen (PSA) levels after radical prostatectomy were included in this retrospective analysis. Tracer uptake was quantified using SUVs. Volumetric parameters, that is, PSMA-derived tumor volume (PSMA-TV) and total lesion PSMA (TL-PSMA), were calculated for each patient using a 3-dimensional segmentation and computerized volumetry technique and compared with serum PSA levels. In a group of 10 patients, volumetric parameters were applied for treatment monitoring. Results: Volumetric parameters, that is, whole-body PSMA-TV and whole-body TL-PSMA, demonstrated a statistically significant correlation with PSA levels (P , 0.0001) as a surrogate marker of tumor burden, whereas SUV max (P 5 0.22) or SUV mean (P 5 0.45) did not. Treatment response and treatment failure were paralleled by concordant changes in both whole-body PSMA-TV and whole-body TL-PSMA (P 5 0.02), whereas neither the change in SUV max (P 5 1.0) nor the change in SUV mean (P 5 1.0) concordantly paralleled changes in PSA levels. Conclusion: PSMA-derived volumetric parameters provide a quantitative imaging biomarker for whole-body tumor burden, capable of standardizing quantitative changes in PET imaging of patients with metastatic prostate cancer and of facilitating therapy monitoring.
doi:10.2967/jnumed.117.193581 pmid:28522740 fatcat:wyfdkb7wabgefjh5aal3xgflsa

Value of PET imaging for radiation therapy

Constantin Lapa, Ursula Nestle, Nathalie L. Albert, Christian Baues, Ambros Beer, Andreas Buck, Volker Budach, Rebecca Bütof, Stephanie E. Combs, Thorsten Derlin, Matthias Eiber, Wolfgang P. Fendler (+65 others)
2021 Strahlentherapie und Onkologie (Print)  
Grosu, Christoph Henkenberens, Harun Ilhan, Steffen Löck, Simone Marnitz-Schulze, Matthias Miederer, Michael Mix, Nils H. Nicolay, Maximilian Niyazi, Christoph Pöttgen, Claus M.  ...  Henkenberens, H. Ilhan, S. Löck, S. Marnitz-Schulze, M. Miederer, M. Mix, N.H. Nicolay, M. Niyazi, C. Pöttgen, C.M. Rödel, I. Schatka, S.M. Schwarzenboeck, A.S. Todica, W. Weber, S. Wegen, T.  ... 
doi:10.1007/s00066-021-01812-2 pmid:34259912 fatcat:2acd54pipfgbpk2mh5gf2kh6aq

Assessment of γ-H2AX and 53BP1 Foci in Peripheral Blood Lymphocytes to Predict Subclinical Hematotoxicity and Response in Somatostatin Receptor-Targeted Radionuclide Therapy for Advanced Gastroenteropancreatic Neuroendocrine Tumors

Thorsten Derlin, Natalia Bogdanova, Fiona Ohlendorf, Dhanya Ramachandran, Rudolf A. Werner, Tobias L. Ross, Hans Christiansen, Frank M. Bengel, Christoph Henkenberens
2021 Cancers  
We aimed to characterize γ-H2AX and 53BP1 foci formation in patients receiving somatostatin receptor-targeted radioligand therapy, and explored its role for predicting treatment-related hematotoxicity, and treatment response. Methods: A prospective analysis of double-strand break (DSB) markers was performed in 21 patients with advanced gastroenteropancreatic neuroendocrine tumors. γ-H2AX and 53BP1 foci formation were evaluated in peripheral blood lymphocytes (PBLs) at baseline, +1 h and +24 h
more » ... ter administration of 7.4 GBq (177Lu)Lu-DOTA-TATE. Hematotoxicity was evaluated using standard hematology. Therapy response was assessed using (68Ga)Ga-DOTA-TATE PET/CT before enrollment and after 2 cycles of PRRT according to the volumetric modification of RECIST 1.1. Results: DSB marker kinetics were heterogeneous among patients. Subclinical hematotoxicity was associated with γ-H2AX and 53BP1 foci formation (e.g., change in platelet count vs change in γ-H2AX+ cells between baseline and +1 h (r = −0.6080; p = 0.0045). Patients showing early development of new metastases had less γ-H2AX (p = 0.0125) and less 53BP1 foci per cell at +1 h (p = 0.0289), and demonstrated a distinct kinetic pattern with an absence of DSB marker decrease at +24 h (γ-H2AX: p = 0.0025; 53BP1: p = 0.0008). Conclusions: Assessment of γ-H2AX and 53BP1 foci formation in PBLs of patients receiving radioligand therapy may hold promise for predicting subclinical hematotoxicity and early treatment response.
doi:10.3390/cancers13071516 pmid:33806081 fatcat:c4nl3rr2xvbqlchzqccwj5aqi4

The Prognostic Value of Irradiated Lung Volumes on the Prediction of Intra-/ Post-Operative Mortality in Patients after Neoadjuvant Radiochemotherapy for Esophageal Cancer. A Retrospective Multicenter Study

Philipp Günther Kup, Carsten Nieder, Hans Geinitz, Christoph Henkenberens, Angela Besserer, Markus Oechsner, Sabine Schill, Ralph Mücke, Vera Scherer, Stephanie E. Combs, Irenäus A. Adamietz, Khashayar Fakhrian
2015 Journal of Cancer  
Purpose: To assess the association between dosimetric factors of the lung and incidence of intraand postoperative mortality among esophageal cancer (EC) patients treated with neoadjuvant radiochemotherapy (N-RCT) followed by surgery (S). Methods and Materials: Inclusion criteria were: age < 85 years, no distant metastases at the time of diagnosis, no induction chemotherapy, conformal radiotherapy, total dose ≤ 50.4 Gy, and available dose volume histogram (DVH) data. One-hundred thirty-five
more » ... nts met our inclusion criteria. Median age was 62 years. N-RCT consisted of 36 -50.4 Gy (median 45 Gy), 1.8 -2 Gy per fraction. Concomitant chemotherapy consisted of 5-Fluoruracil (5-FU) and cisplatin in 113 patients and cisplatin and taxan-derivates in 15 patients. Seven patients received a single cytotoxic agent. In 130 patients an abdominothoracal and in 5 patients a transhiatal resection was performed. The following dosimetric parameters were generated from the total lung DVH: mean dose, V5, V10, V15, V20, V30, V40, V45 and V50. The primary endpoint was the rate of intra-and postoperative mortality (from the start of N-RCT to 60 days after surgical resection). Results: A total of ten postoperative deaths (7%) were observed: 3 within 30 days (2%) and 7 between 30 and 60 days after surgical intervention (5%); no patient died during the operation. In the univariate analysis, weight loss (≥10% in 6 months prior to diagnosis, risk ratio: 1.60, 95%CI: 0.856-2.992, p=0.043), Eastern Cooperative Oncology Group-performance status (ECOG 2 vs. 1, risk ratio: 1.931, 95%CI: 0.898-4.150, p=0.018) and postoperative pulmonary plus non-pulmonary complications (risk ratio: 2.533, 95%CI: 0.978-6.563, p=0.004) were significantly associated with postoperative mortality. There was no significant association between postoperative mortality and irradiated lung volumes. Lung V45 was the only variable which was significantly associated with higher incidence of postoperative pulmonary plus non-pulmonary complications (Exp(B): 1.285, Ivyspring 255 95%CI 1.029-1.606, p=0.027), but not with the postoperative pulmonary complications (Exp(B): 1.249, 95%CI 0.999-1.561, p=0.051). Conclusions: Irradiated lung volumes did not show relevant associations with intra-and postoperative mortality of patients treated with moderate dose (36 -50.4 Gy) conventionally fractionated conformal radiotherapy combined with widely used radiosensitizers. Postoperative mortality was significantly associated with greater weight loss, poor performance status and development of postoperative complications, but not with treatment-related factors. Limiting the volume of lung receiving higher radiation doses appears prudent because of the observed association with risk of postoperative complications.
doi:10.7150/jca.10796 pmid:25663943 pmcid:PMC4317761 fatcat:olxgpdwhhjd5vdbip32eheqhtq

Efficacy of PSMA ligand PET-based radiotherapy for recurrent prostate cancer after radical prostatectomy and salvage radiotherapy

Ann-Kathrin Oehus, Stephanie G. C. Kroeze, Nina-Sophie Schmidt-Hegemann, Marco M. E. Vogel, Simon Kirste, Jessica Becker, Irene A. Burger, Thorsten Derlin, Peter Bartenstein, Matthias Eiber, Michael Mix, Christian la Fougère (+7 others)
2020 BMC Cancer  
A substantial number of patients will develop further biochemical progression after radical prostatectomy (RP) and salvage radiotherapy (sRT). Recently published data using prostate-specific membrane antigen ligand positron emission tomography (PSMA - PET) for re-staging suggest that those recurrences are often located outside the prostate fossa and most of the patients have a limited number of metastases, making them amenable to metastasis-directed treatment (MDT). We analyzed 78 patients with
more » ... biochemical progression after RP and sRT from a retrospective European multicenter database and assessed the biochemical recurrence-free survival (bRFS; PSA < nadir + 0.2 ng/ml or no PSA decline) as well as the androgen deprivation therapy- free survival (ADT-FS) using Kaplan-Meier curves. Log-rank test and multivariate analysis was performed to determine influencing factors. A total of 185 PSMA - PET positive metastases were detected and all lesions were treated with radiotherapy (RT). Concurrent ADT was prescribed in 16.7% (13/78) of patients. The median PSA level before RT was 1.90 ng/mL (range, 0.1-22.1) and decreased statistically significantly to a median PSA nadir level of 0.26 ng/mL (range, 0.0-12.25; p < 0.001). The median PSA level of 0.88 ng/mL (range, 0.0-25.8) at the last follow-up was also statistically significantly lower (p = 0.008) than the median PSA level of 1.9 ng/mL (range, 0.1-22.1) before RT. The median bRFS was 17.0 months (95% CI, 14.2-19.8). After 12 months, 55.3% of patients were free of biochemical progression. Multivariate analyses showed that concurrent ADT was the most important independent factor for bRFS (p = 0.01). The median ADT-FS was not reached and exploratory statistical analyses estimated a median ADT-FS of 34.0 months (95% CI, 16.3-51.7). Multivariate analyses revealed no significant parameters for ADT-FS. RT as MDT based on PSMA - PET of all metastases of recurrent prostate cancer after RP and sRT represents a viable treatment option for well-informed and well-selected patients.
doi:10.1186/s12885-020-06883-5 pmid:32349700 fatcat:jywddejufzfndkj5o462najgui

Combining 68Ga-PSMA-PET/CT-Directed and Elective Radiation Therapy Improves Outcome in Oligorecurrent Prostate Cancer: A Retrospective Multicenter Study

Simon Kirste, Stephanie G. C. Kroeze, Christoph Henkenberens, Nina-Sophie Schmidt-Hegemann, Marco M. E. Vogel, Jessica Becker, Constantinos Zamboglou, Irene Burger, Thorsten Derlin, Peter Bartenstein, Juri Ruf, Christian la Fougère (+7 others)
2021 Frontiers in Oncology  
Copyright © 2021 Kirste, Kroeze, Henkenberens, Schmidt-Hegemann, Vogel, Becker, Zamboglou, Burger, Derlin, Bartenstein, Ruf, la Fougère, Eiber, Christiansen, Combs, Müller, Belka, Guckenberger and Grosu  ... 
doi:10.3389/fonc.2021.640467 pmid:34041020 pmcid:PMC8141738 fatcat:rgkhehbcvvduxnqrkt4tf7gv2u
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