PSMA-PET/CT Affects Choice of Radiation Therapy in Prostate Cancer

WEDNESDAY, Feb. 23, 2022 (HealthDay News) — Incorporating prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) findings affects treatment decisions and selection of radiation therapy (RT) in the management of prostate cancer, according to a study published online Jan. 29 in Radiation Oncology.

Vasileios Karagiannis, from Vaasa Central Hospital in Finland, and colleagues conducted a retrospective pilot study involving 43 prostate cancer patients. ¹⁸F-PSMA-PET/CT was ordered, mainly due to a lack of recent image staging. Patients were divided according to their initially planned treatments: radical RT for newly diagnosed patients; salvage RT for patients with biochemical recurrence after radical prostatectomy; or oligometastatic RT for patients with oligometastatic prostate cancer with good response after systemic treatment.

The researchers found that the initially planned RT was changed for 60.5% of the patients due to new findings (metastases/recurrent disease) following PSMA-PET/CT; of those who underwent PSMA-PET/CT, only 39.5% of patients were treated according to their initial treatment plans. PSMA-PET/CT outcome affected the final treatment choice in 26 of 43 patients, and the radiation treatment plan changed following PSMA-PET/CT in 16 of 32 patients.

“The incorporation of PSMA-PET/CT imaging in planning will change RT treatment and may improve its likelihood of success,” the authors write. “Further prospective randomized studies are urgently needed to confirm that early treatment based on imaging-detected metastases will improve prostate cancer patient outcomes.“

Abstract/Full Text