[11C]choline-PET-guided helical tomotherapy and estramustine in a patient with pelvic-recurrent prostate cancer: local control and toxicity profile after 24 months.
[11C]choline positron emission tomograhy can be useful to detect metastatic disease and to localize isolated lymph node relapse after primary treatment in case of prostate-specific antigen failure. In case of lymph node failure in prostate cancer patients, surgery or radiotherapy can be proposed with a curative intent. Some reports have suggested that radiotherapy could have a role in local control of oligometastatic lymph node disease. This is the first reported case of [11C]choline positron emission tomography-guided helical tomotherapy concomitant with estramustine for the treatment of pelvic-recurrent prostate cancer. At 24 months after the end of helical tomotherapy, prostate-specific antigen was undetectable and no late toxicities were recorded. A disease-free survival of 24 months, in the absence of any type of systemic therapy, is uncommon in metastatic prostate cancer. The therapeutic approach of the case report is discussed and a literature review on the issue is presented.
Radiotherapy Department, San Raffaele Scientific Institute, Milan, Italy. filippoalongi@libero.it
Filippo
F
Alongi
Stefano
S
Schipani
Ana Maria
AM
Samanes Gajate
Alberto
A
Rosso
Cesare
C
Cozzarini
Claudio
C
Fiorino
Pierpaolo
P
Alongi
Maria
M
Picchio
Luigi
L
Gianolli
Cristina
C
Messa
Nadia
N
Di Muzio
D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002250:Carbon Radioisotopes; D017024:Chemotherapy, Adjuvant; D002794:Choline; D004961:Estramustine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy; D010386:Pelvic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000556:secondary; D049268:Positron-Emission Tomography / Q000379:methods; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D018714:Radiotherapy, Adjuvant; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome
D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D002250:Carbon Radioisotopes; D004961:Estramustine; D002794:Choline