Integration of (68)Ga-PSMA-PET imaging in planning of primary definitive radiotherapy in prostate cancer: a retrospective study

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Integration of (68)Ga-PSMA-PET imaging in planning of primary definitive radiotherapy in prostate cancer: a retrospective study : Radiat Oncol. / Dewes, S.; Schiller, K.; Sauter, K.; Eiber, M.; Maurer, T.; Schwaiger, M.; Gschwend, J. E.; Combs, S. E.; Habl, G.

In: RADIAT ONCOL, Vol. 11, 2016, p. 73.

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@article{8af39671baa3462bab5cc171c5e04f1f,
title = "Integration of (68)Ga-PSMA-PET imaging in planning of primary definitive radiotherapy in prostate cancer: a retrospective study: Radiat Oncol",
abstract = "BACKGROUND: Prostate cancer (PC) is one of the most commonly treated cancer entities with radiation therapy (RT). Risk group-adapted treatment and avoidance of unnecessary toxicities relies primarily on accurate tumor staging. Thus, the introduction of prostate-specific membrane antigen (PSMA) in diagnosis and treatment of PC is a highly interesting development in radiation oncology of urologic tumors. The present work is to evaluate the integration of (68)Ga-PSMA-PET imaging into standard radiation planning of primary definitive treatment of PC and to determine the impact of PSMA imaging on tumor staging. METHODS: The data of 15 patients treated for PC between August 2013 and April 2015 were evaluated. Treatment planning included (68)Ga-PSMA-PET imaging. We analyzed whether the use of PSMA-imaging led to a change of the TNM stage and if it influenced the RT treatment approach or the target volume, due to changes in the gross tumor volume (GTV) or clinical target volume (CTV), in the final treatment plan. RESULTS: In 53.3 % of the analyzed patients a change occurred in the TNM stage based on (68)Ga-PSMA-PET examination. The RT concept changed in 33.3 % of all patients, leading to relevant changes in the planning target volume. Among these, an additional irradiation of the pelvic lymph drainage due to tracer uptake in lymph nodes was performed in 25 %. Furthermore, boost volumes of PET-positive lymph nodes were added in 80 % of these cases. A down staging due to the (68)Ga-PSMA-PET examination occurred in 13.3 % of all cases. CONCLUSIONS: The integration of (68)Ga-PSMA-PET-imaging into the RT treatment planning process can be useful for detailed target volume planning. The performance of a (68)Ga-PSMA-PET frequently leads to changes in the TNM stage, altering the RT treatment regimen and the target volume. A prospective trial is underway to evaluate the impact of (68)Ga-PSMA-PET based treatment planning on outcome.",
keywords = "Aged Aged, 80 and over Antigens, Surface/*metabolism Edetic Acid/*analogs & derivatives/pharmacokinetics Follow-Up Studies Glutamate Carboxypeptidase II/*metabolism Humans Male Middle Aged Oligopeptides/*pharmacokinetics Positron-Emission Tomography/*methods Prognosis Prostatic Neoplasms/*diagnostic imaging/metabolism/pathology/*radiotherapy Radiopharmaceuticals/pharmacokinetics Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted/*methods Radiotherapy, Intensity-Modulated Retrospective Studies Tissue Distribution Psma-pet Prostate cancer Radiation oncology Radiation therapy Treatment planning",
author = "S. Dewes and K. Schiller and K. Sauter and M. Eiber and T. Maurer and M. Schwaiger and Gschwend, {J. E.} and Combs, {S. E.} and G. Habl",
note = "1748-717x Dewes, Sabrina Schiller, Kilian Sauter, Katharina Eiber, Matthias Maurer, Tobias Schwaiger, Markus Gschwend, Jurgen E Combs, Stephanie E Habl, Gregor Journal Article Research Support, Non-U.S. Gov't England Radiat Oncol. 2016 May 26;11:73. doi: 10.1186/s13014-016-0646-2.",
year = "2016",
doi = "10.1186/s13014-016-0646-2",
language = "English",
volume = "11",
pages = "73",
journal = "RADIAT ONCOL",
issn = "1748-717X",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Integration of (68)Ga-PSMA-PET imaging in planning of primary definitive radiotherapy in prostate cancer: a retrospective study

T2 - Radiat Oncol

AU - Dewes, S.

AU - Schiller, K.

AU - Sauter, K.

AU - Eiber, M.

AU - Maurer, T.

AU - Schwaiger, M.

AU - Gschwend, J. E.

AU - Combs, S. E.

AU - Habl, G.

N1 - 1748-717x Dewes, Sabrina Schiller, Kilian Sauter, Katharina Eiber, Matthias Maurer, Tobias Schwaiger, Markus Gschwend, Jurgen E Combs, Stephanie E Habl, Gregor Journal Article Research Support, Non-U.S. Gov't England Radiat Oncol. 2016 May 26;11:73. doi: 10.1186/s13014-016-0646-2.

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Prostate cancer (PC) is one of the most commonly treated cancer entities with radiation therapy (RT). Risk group-adapted treatment and avoidance of unnecessary toxicities relies primarily on accurate tumor staging. Thus, the introduction of prostate-specific membrane antigen (PSMA) in diagnosis and treatment of PC is a highly interesting development in radiation oncology of urologic tumors. The present work is to evaluate the integration of (68)Ga-PSMA-PET imaging into standard radiation planning of primary definitive treatment of PC and to determine the impact of PSMA imaging on tumor staging. METHODS: The data of 15 patients treated for PC between August 2013 and April 2015 were evaluated. Treatment planning included (68)Ga-PSMA-PET imaging. We analyzed whether the use of PSMA-imaging led to a change of the TNM stage and if it influenced the RT treatment approach or the target volume, due to changes in the gross tumor volume (GTV) or clinical target volume (CTV), in the final treatment plan. RESULTS: In 53.3 % of the analyzed patients a change occurred in the TNM stage based on (68)Ga-PSMA-PET examination. The RT concept changed in 33.3 % of all patients, leading to relevant changes in the planning target volume. Among these, an additional irradiation of the pelvic lymph drainage due to tracer uptake in lymph nodes was performed in 25 %. Furthermore, boost volumes of PET-positive lymph nodes were added in 80 % of these cases. A down staging due to the (68)Ga-PSMA-PET examination occurred in 13.3 % of all cases. CONCLUSIONS: The integration of (68)Ga-PSMA-PET-imaging into the RT treatment planning process can be useful for detailed target volume planning. The performance of a (68)Ga-PSMA-PET frequently leads to changes in the TNM stage, altering the RT treatment regimen and the target volume. A prospective trial is underway to evaluate the impact of (68)Ga-PSMA-PET based treatment planning on outcome.

AB - BACKGROUND: Prostate cancer (PC) is one of the most commonly treated cancer entities with radiation therapy (RT). Risk group-adapted treatment and avoidance of unnecessary toxicities relies primarily on accurate tumor staging. Thus, the introduction of prostate-specific membrane antigen (PSMA) in diagnosis and treatment of PC is a highly interesting development in radiation oncology of urologic tumors. The present work is to evaluate the integration of (68)Ga-PSMA-PET imaging into standard radiation planning of primary definitive treatment of PC and to determine the impact of PSMA imaging on tumor staging. METHODS: The data of 15 patients treated for PC between August 2013 and April 2015 were evaluated. Treatment planning included (68)Ga-PSMA-PET imaging. We analyzed whether the use of PSMA-imaging led to a change of the TNM stage and if it influenced the RT treatment approach or the target volume, due to changes in the gross tumor volume (GTV) or clinical target volume (CTV), in the final treatment plan. RESULTS: In 53.3 % of the analyzed patients a change occurred in the TNM stage based on (68)Ga-PSMA-PET examination. The RT concept changed in 33.3 % of all patients, leading to relevant changes in the planning target volume. Among these, an additional irradiation of the pelvic lymph drainage due to tracer uptake in lymph nodes was performed in 25 %. Furthermore, boost volumes of PET-positive lymph nodes were added in 80 % of these cases. A down staging due to the (68)Ga-PSMA-PET examination occurred in 13.3 % of all cases. CONCLUSIONS: The integration of (68)Ga-PSMA-PET-imaging into the RT treatment planning process can be useful for detailed target volume planning. The performance of a (68)Ga-PSMA-PET frequently leads to changes in the TNM stage, altering the RT treatment regimen and the target volume. A prospective trial is underway to evaluate the impact of (68)Ga-PSMA-PET based treatment planning on outcome.

KW - Aged Aged, 80 and over Antigens, Surface/metabolism Edetic Acid/analogs & derivatives/pharmacokinetics Follow-Up Studies Glutamate Carboxypeptidase II/metabolism Humans Male Middle Aged Oligopeptides/pharmacokinetics Positron-Emission Tomography/methods P

U2 - 10.1186/s13014-016-0646-2

DO - 10.1186/s13014-016-0646-2

M3 - SCORING: Journal article

VL - 11

SP - 73

JO - RADIAT ONCOL

JF - RADIAT ONCOL

SN - 1748-717X

ER -