PSMA PET/CT patterns of recurrence after mono-brachytherapy in men with low and intermediate prostate cancer and subsequent management

Loos, G; Buteau, JP; Oh, J; Van Dyk, S; Chang, D; Murphy, DG; Hofman, MS; Williams, S; Chander, S

Author(s): Loos, G; Buteau, JP; Oh, J; Van Dyk, S; Chang, D; Murphy, DG; Hofman, MS; Williams, S; Chander, S;
Details: Publication Year 2024-11,Volume 23,Issue #6,Page 719-726
Journal Title: Brachytherapy
Publication Type: Review
Abstract: PURPOSE: Brachytherapy as monotherapy is a recommended treatment option for men with low to intermediate risk prostate cancer. Local recurrence is difficult to identify. This study investigated PSMA PET/CT for recurrence after brachytherapy, as well as their subsequent management when recurrence occurred only within the prostate. METHODS: We performed a retrospective single-center analysis for patients who were treated with brachytherapy as monotherapy for prostate cancer from May 2002 to May 2021 and who underwent a PSMA PET/CT for BCR. We report the findings on PSMA PET/CT, quantitative parameters, as well as the later management of the patients. RESULTS: Forty patients were identified, who underwent PSMA PET/CT to investigate a rising PSA at a median (IQR) of 7 years (3.0-10.8) after initial therapy. Median (IQR) PSA at time of PSMA PET/CT was 6.54 ng/mL (3.9-15.5). On PSMA PET/CT, 20/40 (50%) men had prostate-only recurrence. Of the 20 patients with prostate-only recurrence, 8/20 (40%) had recurrence in a high-dose radiation zone, versus 7/20 (35%) in an under-covered zone. On PSMA PET/CT, recurrence within the prostate had median (IQR) SUVmax 10.4 (5.1-15.7) and volume 2.9 mL (2.0-11.2). Subsequent management of these patients with local recurrence included surveillance followed by ADT (9/20, 45%). For those with surveillance followed by ADT, the mean time before introduction of ADT was 4.1 years (range 1-8 years).
Publisher: Elsevier
Keywords: Humans; Male; *Positron Emission Tomography Computed Tomography/methods; *Prostatic Neoplasms/radiotherapy/diagnostic imaging; *Brachytherapy/methods; *Neoplasm Recurrence, Local/radiotherapy/diagnostic imaging; Retrospective Studies; Aged; Middle Aged; *Prostate-Specific Antigen/blood; Active surveillance; HDR brachytherapy; LDR brachytherapy; Local recurrence after radiation therapy; Psma pet/ct; Prostate cancer
Department(s): Radiation Oncology; Cancer Imaging; Surgical Oncology
Publisher's Version: https://doi.org/10.1016/j.brachy.2024.07.003
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-12-17 03:14:03

Last Modified: 2024-12-17 03:15:01