Metabolic response after 68Ga-PSMA-PET/CT-directed IGRT/SBRT for oligometastases prostate cancer

Clin Transl Oncol. 2023 Apr;25(4):987-994. doi: 10.1007/s12094-022-03002-7. Epub 2022 Nov 11.

Abstract

Background: We used 68Ga PSMA PET/CT in the current investigation to assess the metabolic response and local control of metastasis in patients with oligometastatic prostate cancer receiving SBRT.

Materials and procedures: We performed a retrospective evaluation of the medical data of all patients with oligometastatic prostate cancer who underwent stereotactic body radiation therapy (SBRT) between 2017 and 2021. Our analysis only included medical records of patients who had SBRT for oligometastatic prostate cancer and had pre and post-SBRT 68Ga PSMA PET/CT images. Patient-related (age), disease-related (Gleason score, location of metastases), and treatment-related (factors and outcomes) data were collected from the medical files.

Results: A total of 17 patients (28 lesions) with a median age of 69 years were included in the research. A median follow-up of 16.6 months was used (range 6-36 months). The median follow-up period for 68 Ga PSMA PET/CT was 8 months (the range was 5-24 months). The median pre-treatment PSA level was 1.7 ng/mL (range 0.39-18.3 ng/mL) compared to the post-treatment PSA nadir of 0.05 ng/mL (0.02-4.57). During the follow-up period, local control was 96%, and there was a link between PSMA avidity on PET. In the treated lesions, there were no recurrences. During follow-up, none of the patients experienced toxicities of grade 3 or above.

Conclusions: SBRT is a highly successful and safe way of treating patients with oligometastatic prostate cancer. Additional research is needed to examine 68Ga PSMA PET/CT to assess further for demarcation and follow-up.

Keywords: Oligometastatic; PSMA-PET; Prostate cancer; SBRT.

MeSH terms

  • Aged
  • Humans
  • Male
  • Positron Emission Tomography Computed Tomography / methods
  • Prostate-Specific Antigen
  • Prostatic Neoplasms* / diagnostic imaging
  • Prostatic Neoplasms* / pathology
  • Prostatic Neoplasms* / radiotherapy
  • Radiosurgery* / methods
  • Retrospective Studies

Substances

  • gallium 68 PSMA-11
  • Prostate-Specific Antigen