Francesco Lanfranchi, Liliana Belgioia, Domenico Albano, Luca Triggiani, Flavia Linguanti, Luca Urso, Rosario Mazzola, Alessio Rizzo, Elisa D'Angelo, Francesco Dondi, Eneida Mataj, Gloria Pedersoli, Elisabetta Maria Abenavoli, Luca Vaggelli, Beatrice Detti, Naima Ortolan, Antonio Malorgio, Alessia Guarneri, Federico Garrou, Matilde Fiorini, Serena Grimaldi, Pietro Ghedini, Giuseppe Carlo Iorio, Antonella Iudicello, Guido Rovera, Giuseppe Fornarini, Diego Bongiovanni, Michela Marcenaro, Filippo Maria Pazienza, Giorgia Timon, Matteo Salgarello, Manuela Racca, Mirco Bartolomei, Stefano Panareo, Umberto Ricardi, Francesco Bertagna, Filippo Alongi, Salvina Barra, Silvia Morbelli, Gianmario Sambuceti, Matteo Bauckneht
{"title":"不同PET/CT示踪剂引导的转移性治疗对少复发激素敏感前列腺癌远处和局部疾病控制的影响：precision - mdt研究的二次分析","authors":"Francesco Lanfranchi, Liliana Belgioia, Domenico Albano, Luca Triggiani, Flavia Linguanti, Luca Urso, Rosario Mazzola, Alessio Rizzo, Elisa D'Angelo, Francesco Dondi, Eneida Mataj, Gloria Pedersoli, Elisabetta Maria Abenavoli, Luca Vaggelli, Beatrice Detti, Naima Ortolan, Antonio Malorgio, Alessia Guarneri, Federico Garrou, Matilde Fiorini, Serena Grimaldi, Pietro Ghedini, Giuseppe Carlo Iorio, Antonella Iudicello, Guido Rovera, Giuseppe Fornarini, Diego Bongiovanni, Michela Marcenaro, Filippo Maria Pazienza, Giorgia Timon, Matteo Salgarello, Manuela Racca, Mirco Bartolomei, Stefano Panareo, Umberto Ricardi, Francesco Bertagna, Filippo Alongi, Salvina Barra, Silvia Morbelli, Gianmario Sambuceti, Matteo Bauckneht","doi":"10.1148/rycan.240150","DOIUrl":null,"url":null,"abstract":"<p><p>Prospective trials suggest that metastasis-directed therapy (MDT) is an effective treatment for patients with oligometastatic prostate cancer (PCa). Gallium 68 (<sup>68</sup>Ga) prostate-specific membrane antigen (PSMA)-11 PET/CT-guided MDT seems to improve the oncologic outcome in these patients compared with fluorine 18 (<sup>18</sup>F)-fluorocholine and <sup>18</sup>F-PSMA-1007 PET/CT-guided MDT, but the effects in terms of local or distant disease control remain unclear. Thus, the present subanalysis of the PRECISE-MDT study analyzed patients with hormone-sensitive PCa who underwent MDT guided by PET/CT for nodal or bone oligorecurrent disease and were restaged with the same imaging modality in case of biochemical recurrence after MDT. Among 340 lesions detected in 241 male patients (median age, 74 [IQR, 9] years), <sup>18</sup>F-fluorocholine, <sup>68</sup>Ga-PSMA-11, and <sup>18</sup>F-PSMA-1007 PET/CT-guided MDT was performed in 179, 81, and 80 lesions, respectively. At restaging imaging, the PET/CT imaging modality used to guide MDT was not significantly associated with local recurrence-free survival (LRFS), with median LRFS not reached for <sup>68</sup>Ga-PSMA-11 PET/CT, <sup>18</sup>F-PSMA-11 PET/CT, and <sup>18</sup>F-fluorocholine PET/CT (<i>P</i> = .73). However, the detection rate of a new metastasis was significantly higher if MDT was guided by <sup>18</sup>F-fluorocholine PET/CT (119 of 179 lesions, 66.5%) compared with <sup>68</sup>Ga-PSMA-11 or <sup>18</sup>F-PSMA-1007 PET/CT (23 of 81 lesions, 28%, and 27 of 80, 34%, respectively; <i>P</i> < .001 for both). Moreover, MDT guided by <sup>68</sup>Ga-PSMA-11 PET/CT led to an improved median metastasis-free survival (MFS) (not reached) compared with <sup>18</sup>F-PSMA-1007 (median MFS, 24.9 months; <i>P</i> < .001) or <sup>18</sup>F-fluorocholine PET/CT (median MFS, 18 months; <i>P</i> < .001). These findings suggest that using different PET/CT imaging modalities to guide MDT might impact the distant disease control in this clinical scenario. <b>Keywords:</b> Radiation Therapy, Oncology, Urinary, Prostate, PET/CT <i>Supplemental material is available for this article.</i> Published under a CC BY 4.0 license.</p>","PeriodicalId":20786,"journal":{"name":"Radiology. Imaging cancer","volume":"7 3","pages":"e240150"},"PeriodicalIF":5.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Metastasis-directed Therapy Guided by Different PET/CT Radiotracers on Distant and Local Disease Control in Oligorecurrent Hormone-sensitive Prostate Cancer: A Secondary Analysis of the PRECISE-MDT Study.\",\"authors\":\"Francesco Lanfranchi, Liliana Belgioia, Domenico Albano, Luca Triggiani, Flavia Linguanti, Luca Urso, Rosario Mazzola, Alessio Rizzo, Elisa D'Angelo, Francesco Dondi, Eneida Mataj, Gloria Pedersoli, Elisabetta Maria Abenavoli, Luca Vaggelli, Beatrice Detti, Naima Ortolan, Antonio Malorgio, Alessia Guarneri, Federico Garrou, Matilde Fiorini, Serena Grimaldi, Pietro Ghedini, Giuseppe Carlo Iorio, Antonella Iudicello, Guido Rovera, Giuseppe Fornarini, Diego Bongiovanni, Michela Marcenaro, Filippo Maria Pazienza, Giorgia Timon, Matteo Salgarello, Manuela Racca, Mirco Bartolomei, Stefano Panareo, Umberto Ricardi, Francesco Bertagna, Filippo Alongi, Salvina Barra, Silvia Morbelli, Gianmario Sambuceti, Matteo Bauckneht\",\"doi\":\"10.1148/rycan.240150\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Prospective trials suggest that metastasis-directed therapy (MDT) is an effective treatment for patients with oligometastatic prostate cancer (PCa). Gallium 68 (<sup>68</sup>Ga) prostate-specific membrane antigen (PSMA)-11 PET/CT-guided MDT seems to improve the oncologic outcome in these patients compared with fluorine 18 (<sup>18</sup>F)-fluorocholine and <sup>18</sup>F-PSMA-1007 PET/CT-guided MDT, but the effects in terms of local or distant disease control remain unclear. Thus, the present subanalysis of the PRECISE-MDT study analyzed patients with hormone-sensitive PCa who underwent MDT guided by PET/CT for nodal or bone oligorecurrent disease and were restaged with the same imaging modality in case of biochemical recurrence after MDT. Among 340 lesions detected in 241 male patients (median age, 74 [IQR, 9] years), <sup>18</sup>F-fluorocholine, <sup>68</sup>Ga-PSMA-11, and <sup>18</sup>F-PSMA-1007 PET/CT-guided MDT was performed in 179, 81, and 80 lesions, respectively. At restaging imaging, the PET/CT imaging modality used to guide MDT was not significantly associated with local recurrence-free survival (LRFS), with median LRFS not reached for <sup>68</sup>Ga-PSMA-11 PET/CT, <sup>18</sup>F-PSMA-11 PET/CT, and <sup>18</sup>F-fluorocholine PET/CT (<i>P</i> = .73). However, the detection rate of a new metastasis was significantly higher if MDT was guided by <sup>18</sup>F-fluorocholine PET/CT (119 of 179 lesions, 66.5%) compared with <sup>68</sup>Ga-PSMA-11 or <sup>18</sup>F-PSMA-1007 PET/CT (23 of 81 lesions, 28%, and 27 of 80, 34%, respectively; <i>P</i> < .001 for both). Moreover, MDT guided by <sup>68</sup>Ga-PSMA-11 PET/CT led to an improved median metastasis-free survival (MFS) (not reached) compared with <sup>18</sup>F-PSMA-1007 (median MFS, 24.9 months; <i>P</i> < .001) or <sup>18</sup>F-fluorocholine PET/CT (median MFS, 18 months; <i>P</i> < .001). These findings suggest that using different PET/CT imaging modalities to guide MDT might impact the distant disease control in this clinical scenario. <b>Keywords:</b> Radiation Therapy, Oncology, Urinary, Prostate, PET/CT <i>Supplemental material is available for this article.</i> Published under a CC BY 4.0 license.</p>\",\"PeriodicalId\":20786,\"journal\":{\"name\":\"Radiology. Imaging cancer\",\"volume\":\"7 3\",\"pages\":\"e240150\"},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiology. 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Impact of Metastasis-directed Therapy Guided by Different PET/CT Radiotracers on Distant and Local Disease Control in Oligorecurrent Hormone-sensitive Prostate Cancer: A Secondary Analysis of the PRECISE-MDT Study.
Prospective trials suggest that metastasis-directed therapy (MDT) is an effective treatment for patients with oligometastatic prostate cancer (PCa). Gallium 68 (68Ga) prostate-specific membrane antigen (PSMA)-11 PET/CT-guided MDT seems to improve the oncologic outcome in these patients compared with fluorine 18 (18F)-fluorocholine and 18F-PSMA-1007 PET/CT-guided MDT, but the effects in terms of local or distant disease control remain unclear. Thus, the present subanalysis of the PRECISE-MDT study analyzed patients with hormone-sensitive PCa who underwent MDT guided by PET/CT for nodal or bone oligorecurrent disease and were restaged with the same imaging modality in case of biochemical recurrence after MDT. Among 340 lesions detected in 241 male patients (median age, 74 [IQR, 9] years), 18F-fluorocholine, 68Ga-PSMA-11, and 18F-PSMA-1007 PET/CT-guided MDT was performed in 179, 81, and 80 lesions, respectively. At restaging imaging, the PET/CT imaging modality used to guide MDT was not significantly associated with local recurrence-free survival (LRFS), with median LRFS not reached for 68Ga-PSMA-11 PET/CT, 18F-PSMA-11 PET/CT, and 18F-fluorocholine PET/CT (P = .73). However, the detection rate of a new metastasis was significantly higher if MDT was guided by 18F-fluorocholine PET/CT (119 of 179 lesions, 66.5%) compared with 68Ga-PSMA-11 or 18F-PSMA-1007 PET/CT (23 of 81 lesions, 28%, and 27 of 80, 34%, respectively; P < .001 for both). Moreover, MDT guided by 68Ga-PSMA-11 PET/CT led to an improved median metastasis-free survival (MFS) (not reached) compared with 18F-PSMA-1007 (median MFS, 24.9 months; P < .001) or 18F-fluorocholine PET/CT (median MFS, 18 months; P < .001). These findings suggest that using different PET/CT imaging modalities to guide MDT might impact the distant disease control in this clinical scenario. Keywords: Radiation Therapy, Oncology, Urinary, Prostate, PET/CT Supplemental material is available for this article. Published under a CC BY 4.0 license.
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