Influence of molecular imaging on patient selection for treatment intensification prior to salvage radiation therapy for prostate cancer: a post hoc analysis of the PROPS trial.
Date
2023-06-08ICR Author
Author
Tremblay, S
Alhogbani, M
Weickhardt, A
Davis, ID
Scott, AM
Hicks, RJ
Metser, U
Chua, S
Davda, R
Punwani, S
Payne, H
Tunariu, N
Ho, B
Young, S
Singbo, MNU
Bauman, G
Emmett, L
Pouliot, F
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: The impact of molecular imaging (MI) on patient management after biochemical recurrence (BCR) following radical prostatectomy has been described in many studies. However, it is not known if MI-induced management changes are appropriate. This study aimed to determine if androgen deprivation therapy (ADT) management plan is improved by MI in patients who are candidates for salvage radiation therapy. METHODS: Data were analyzed from the multicenter prospective PROPS trial evaluating PSMA/Choline PET in patients being considered for salvage radiotherapy (sRT) with BCR after prostatectomy. We compared the pre- and post-MI ADT management plans for each patient and cancer outcomes as predicted by the MSKCC nomogram. A higher percentage of predicted BCR associated with ADT treatment intensification after MI was considered as an improvement in a patient's management. RESULTS: Seventy-three patients with a median PSA of 0.38 ng/mL were included. In bivariate analysis, a positive finding on MI (local or metastatic) was associated with decision to use ADT with an odds ratio of 3.67 (95% CI, 1.25 to 10.71; p = 0.02). No factor included in the nomogram was associated with decision to use ADT. Also, MI improved selection of patients to receive ADT based on predicted BCR after sRT : the predicted nomogram 5-year biochemical-free survivals were 52.5% and 43.3%, (mean difference, 9.2%; 95% CI 0.8 to 17.6; p = 0.03) for sRT alone and ADT±sRT subgroups, while there was no statistically significant difference between subgroups before MI. CONCLUSIONS: PSMA and/or Choline PET/CT before sRT can potentially improve patient ADT management by directing clinicians towards more appropriate intensification.
Collections
Subject
Biochemical recurrence
Choline
Molecular imaging
PSMA
Prostate cancer
Male
Humans
Prostatic Neoplasms
Patient Selection
Prostate-Specific Antigen
Positron Emission Tomography Computed Tomography
Androgen Antagonists
Prospective Studies
Neoplasm Recurrence, Local
Prostatectomy
Choline
Retrospective Studies
Language
eng
Date accepted
2023-05-15
License start date
2023-06-08
Citation
Cancer Imaging, 2023, 23 (1), pp. 57 -
Publisher
BMC