3-Year Freedom from Progression After 68Ga-PSMA PET/CT–Triaged Management in Men with Biochemical Recurrence After Radical Prostatectomy: Results of a Prospective Multicenter Trial

作者：Louise Emmett, Reuben Tang, Rohan Nandurkar, George Hruby, Paul Roach, J. Watts, Thomas W. Cusick, Andrew Kneebone, Bao Ho, Lyn Chan, Pim J. van Leeuwen, Matthijs J. Scheltema, Andrew Nguyen, Charlotte Yin, Andrew Scott, Colin Tang, Michael McCarthy, Karen Fullard, Matthew J. Roberts, Roslyn J. Francis, Phillip D. Stricker · 发表于：Journal of Nuclear Medicine · 年份：2019 · DOI：10.2967/jnumed.119.235028 · 被引用次数：151 · 研究领域：Prostate Cancer Treatment and Research、Prostate Cancer Diagnosis and Treatment、Urologic and reproductive health conditions

68Ga-labeled prostate-specific membrane antigen (PSMA) PET/CT is increasingly used in men with biochemical recurrence (BCR) after radical prostatectomy (RP), but its longer-term prognostic or predictive potential in these men is unknown. The aim of this study was to evaluate the predictive value of PSMA PET for a 3-y freedom from progression (FFP) in men with BCR after RP undergoing salvage radiotherapy (sRT). Methods: This prospective multicenter study enrolled 260 men between 2015 and 2017. Eligible patients were referred for PSMA PET with a rising level of prostate-specific antigen (PSA) after RP. Management after PSMA PET was recorded but not mandated. PSMA PET protocols were standardized across sites and reported prospectively. Clinical, pathologic, and surgical information; sRT; timing and duration of androgen deprivation; 3-y PSA results; and clinical events were documented. FFP was defined as a PSA rise of no more than 0.2 ng/mL above nadir after sRT, with no additional treatment. Results: The median PSA was 0.26 ng/mL (interquartile range, 0.15–0.59 ng/mL), and follow-up was 38 mo (interquartile range, 31–43 mo). PSMA PET had negative results in 34.6% (90/260), showed disease confined to the prostatic fossa in 21.5% (56/260), showed disease in the pelvic nodes in 26.2% (68/260), and showed distant disease in 17.7% (46/260). Of the patients, 71.5% (186/260) received sRT: 38.2% (71/186) to the fossa only, 49.4% (92/186) to the fossa plus the pelvic nodes, and 12.4% (23...