18F-DCFPyL PSMA-PET影响生化失败前列腺切除术后患者补救性放疗的管理:一项匹配队列研究

Canadian Urological Association journal = Journal de l'Association des urologues du Canada Pub Date : 2023-08-01 DOI:10.5489/cuaj.8165

Andrew J Arifin, Stephanie Gulstene, Andrew Warner, Glenn S Bauman, Lucas C Mendez

{"title":"18F-DCFPyL PSMA-PET影响生化失败前列腺切除术后患者补救性放疗的管理:一项匹配队列研究","authors":"Andrew J Arifin, Stephanie Gulstene, Andrew Warner, Glenn S Bauman, Lucas C Mendez","doi":"10.5489/cuaj.8165","DOIUrl":null,"url":null,"abstract":"INTRODUCTION\nOur objective was to assess the effect of 18F-DCFPyL prostate-specific membrane antigen (PSMA) positron emission tomography (PET) on the management and outcomes of patients receiving salvage radiotherapy following biochemical failure (BF) post-radical prostatectomy (RP) using a matched cohort analysis.\n\n\nMETHODS\nA PSMA-PET cohort of patients with BF post-RP was identified through a prospective registry. Patients from this registry were included if they did not have disease outside of the pelvis and underwent salvage radiotherapy to the prostate and/or pelvis. Case-control matching was performed with a contemporary cohort of patients with BF post-RP without PSMA-PET information.\n\n\nRESULTS\nForty-four patients were included in the PSMA-PET cohort and 80 were analyzed in the non-PSMA-PET cohort. The PSMA-PET cohort had a significantly higher pre-radiotherapy median prostate-specific antigen (PSA) of 0.48 ng/mL compared to 0.20 ng/mL in the non-PSMA-PET cohort (p<0.001), but these levels were similar after matching. The PSMA-PET cohort had a higher proportion of patients receiving radiotherapy to pelvic lymph nodes (n=27 [61.4%] vs. n=16 [20.0%], p<0.001). Median followup was 26 months (interquartile range 18.8-33) for both cohorts. BF-free survival and event-free survival were not significantly different between the two cohorts for all (p=0.662 and >0.99) and matched patients (p=0.808 and 0.808), respectively. Metastasis-free survival was significantly higher in the matched PSMA-PET cohort compared to the matched non-PSMA-PET cohort (p=0.046), although a higher proportion of patients in the non-PSMA-PET cohort underwent PSMA-PET restaging after BF (52% vs. 20%, p=0.08726).\n\n\nCONCLUSIONS\nOur study showed that patients undergoing PSMA-PET scans after BF post-RP had a higher likelihood of pelvic nodal treatment at the time of salvage RT. Despite higher PSA levels at salvage, we identified no recurrence or survival differences.","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":"17 8","pages":"247-253"},"PeriodicalIF":0.0000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426430/pdf/cuaj-8-247.pdf","citationCount":"1","resultStr":"{\"title\":\"<sup>18</sup>F-DCFPyL PSMA-PET affects management of salvage radiotherapy for post-prostatectomy patients with biochemical failure: A matched cohort study.\",\"authors\":\"Andrew J Arifin, Stephanie Gulstene, Andrew Warner, Glenn S Bauman, Lucas C Mendez\",\"doi\":\"10.5489/cuaj.8165\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"INTRODUCTION\\nOur objective was to assess the effect of 18F-DCFPyL prostate-specific membrane antigen (PSMA) positron emission tomography (PET) on the management and outcomes of patients receiving salvage radiotherapy following biochemical failure (BF) post-radical prostatectomy (RP) using a matched cohort analysis.\\n\\n\\nMETHODS\\nA PSMA-PET cohort of patients with BF post-RP was identified through a prospective registry. Patients from this registry were included if they did not have disease outside of the pelvis and underwent salvage radiotherapy to the prostate and/or pelvis. Case-control matching was performed with a contemporary cohort of patients with BF post-RP without PSMA-PET information.\\n\\n\\nRESULTS\\nForty-four patients were included in the PSMA-PET cohort and 80 were analyzed in the non-PSMA-PET cohort. The PSMA-PET cohort had a significantly higher pre-radiotherapy median prostate-specific antigen (PSA) of 0.48 ng/mL compared to 0.20 ng/mL in the non-PSMA-PET cohort (p<0.001), but these levels were similar after matching. The PSMA-PET cohort had a higher proportion of patients receiving radiotherapy to pelvic lymph nodes (n=27 [61.4%] vs. n=16 [20.0%], p<0.001). Median followup was 26 months (interquartile range 18.8-33) for both cohorts. BF-free survival and event-free survival were not significantly different between the two cohorts for all (p=0.662 and >0.99) and matched patients (p=0.808 and 0.808), respectively. Metastasis-free survival was significantly higher in the matched PSMA-PET cohort compared to the matched non-PSMA-PET cohort (p=0.046), although a higher proportion of patients in the non-PSMA-PET cohort underwent PSMA-PET restaging after BF (52% vs. 20%, p=0.08726).\\n\\n\\nCONCLUSIONS\\nOur study showed that patients undergoing PSMA-PET scans after BF post-RP had a higher likelihood of pelvic nodal treatment at the time of salvage RT. Despite higher PSA levels at salvage, we identified no recurrence or survival differences.\",\"PeriodicalId\":9574,\"journal\":{\"name\":\"Canadian Urological Association journal = Journal de l'Association des urologues du Canada\",\"volume\":\"17 8\",\"pages\":\"247-253\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426430/pdf/cuaj-8-247.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Urological Association journal = Journal de l'Association des urologues du Canada\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5489/cuaj.8165\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5489/cuaj.8165","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 1

摘要

前言:我们的目的是通过匹配队列分析，评估18F-DCFPyL前列腺特异性膜抗原(PSMA)正电子发射断层扫描(PET)对根治性前列腺切除术(RP)后生化失败(BF)患者接受补偿性放疗的管理和结果的影响。方法:通过前瞻性登记，对rp后BF患者进行PSMA-PET队列研究。如果患者没有骨盆外的疾病，并接受了前列腺和/或骨盆的补救性放疗，则纳入该登记处的患者。在没有PSMA-PET信息的rp后BF患者的当代队列中进行病例对照匹配。结果:44例患者被纳入PSMA-PET队列，80例患者被纳入非PSMA-PET队列。PSMA-PET组放疗前前列腺特异性抗原(PSA)中位值为0.48 ng/mL，显著高于非PSMA-PET组(p0.99)和匹配组(p=0.808和0.808)的0.20 ng/mL。与非PSMA-PET组相比，匹配的PSMA-PET组的无转移生存率显著更高(p=0.046)，尽管非PSMA-PET组中BF后进行PSMA-PET再分期的患者比例更高(52%对20%，p=0.08726)。结论:我们的研究表明，在BF - rp术后接受PSMA-PET扫描的患者在补救性放疗时盆腔淋巴结治疗的可能性更高。尽管在补救性放疗时PSA水平较高，但我们没有发现复发或生存差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

¹⁸F-DCFPyL PSMA-PET affects management of salvage radiotherapy for post-prostatectomy patients with biochemical failure: A matched cohort study.

INTRODUCTION Our objective was to assess the effect of 18F-DCFPyL prostate-specific membrane antigen (PSMA) positron emission tomography (PET) on the management and outcomes of patients receiving salvage radiotherapy following biochemical failure (BF) post-radical prostatectomy (RP) using a matched cohort analysis. METHODS A PSMA-PET cohort of patients with BF post-RP was identified through a prospective registry. Patients from this registry were included if they did not have disease outside of the pelvis and underwent salvage radiotherapy to the prostate and/or pelvis. Case-control matching was performed with a contemporary cohort of patients with BF post-RP without PSMA-PET information. RESULTS Forty-four patients were included in the PSMA-PET cohort and 80 were analyzed in the non-PSMA-PET cohort. The PSMA-PET cohort had a significantly higher pre-radiotherapy median prostate-specific antigen (PSA) of 0.48 ng/mL compared to 0.20 ng/mL in the non-PSMA-PET cohort (p<0.001), but these levels were similar after matching. The PSMA-PET cohort had a higher proportion of patients receiving radiotherapy to pelvic lymph nodes (n=27 [61.4%] vs. n=16 [20.0%], p<0.001). Median followup was 26 months (interquartile range 18.8-33) for both cohorts. BF-free survival and event-free survival were not significantly different between the two cohorts for all (p=0.662 and >0.99) and matched patients (p=0.808 and 0.808), respectively. Metastasis-free survival was significantly higher in the matched PSMA-PET cohort compared to the matched non-PSMA-PET cohort (p=0.046), although a higher proportion of patients in the non-PSMA-PET cohort underwent PSMA-PET restaging after BF (52% vs. 20%, p=0.08726). CONCLUSIONS Our study showed that patients undergoing PSMA-PET scans after BF post-RP had a higher likelihood of pelvic nodal treatment at the time of salvage RT. Despite higher PSA levels at salvage, we identified no recurrence or survival differences.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

自引率

0.00%

发文量