title: ¹⁸F-choline positron emission tomography/computed tomography-driven high-dose salvage radiation therapy in patients with biochemical progression after radical prostatectomy: feasibility study in 60 patients.
abstract: OBJECTIVE
  To retrospectively review data of a cohort of patients with biochemical progression after radical prostatectomy, treated according to a uniform institutional treatment policy, to evaluate toxicity and feasibility of high-dose salvage radiation therapy (80 Gy).
  
  
  METHODS
  Data on 60 patients with biochemical progression after radical prostatectomy between January 2009 and September 2011 were reviewed. The median value of prostate-specific antigen before radiation therapy was 0.9 ng/mL. All patients at time of diagnosis of biochemical recurrence underwent dynamic (18)F-choline positron emission tomography/computed tomography (PET/CT), which revealed in all cases a local recurrence. High-dose salvage radiation therapy was delivered up to total dose of 80 Gy to 18F-choline PET/CT-positive area. Toxicity was recorded according to the Common Terminology Criteria for Adverse Events, version 3.0, scale.
  
  
  RESULTS
  Treatment was generally well tolerated: 54 patients (90%) completed salvage radiation therapy without any interruption. Gastrointestinal grade ≥2 acute toxicity was recorded in 6 patients (10%), whereas no patient experienced a grade ≥2 genitourinary toxicity. No grade 4 acute toxicity events were recorded. Only 1 patient (1.7%) experienced a grade 2 gastrointestinal late toxicity. With a mean follow-up of 31.2 months, 46 of 60 patients (76.6%) were free of recurrence. The 3-year biochemical progression-free survival rate was 72.5%.
  
  
  CONCLUSIONS
  At early follow-up, (18)F-choline PET/CT-driven high-dose salvage radiation therapy seems to be feasible and well tolerated, with a low rate of toxicity.
authors.affiliation: Radiation Oncology, Campus Bio-Medico University, Rome, Italy. Electronic address: r.dangelillo@unicampus.it.
authors.forename: Rolando M
authors.initials: RM
authors.lastname: D'Angelillo
authors.affiliation: Department of Nuclear Medicine, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Sciuto
authors.affiliation: Radiation Oncology, Campus Bio-Medico University, Rome, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Ramella
authors.affiliation: Department of Urology, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Papalia
authors.affiliation: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy; Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Jereczek-Fossa
authors.affiliation: Radiation Oncology, Campus Bio-Medico University, Rome, Italy.
authors.forename: Luca E
authors.initials: LE
authors.lastname: Trodella
authors.affiliation: Radiation Oncology, Campus Bio-Medico University, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Fiore
authors.affiliation: Department of Urology, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Gallucci
authors.affiliation: Department of Nuclear Medicine, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Carlo L
authors.initials: CL
authors.lastname: Maini
authors.affiliation: Radiation Oncology, Campus Bio-Medico University, Rome, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Trodella
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002794:Choline / Q000031:analogs & derivatives*; D018450:Disease Progression; D005240:Feasibility Studies; D005462:Fluorine Radioisotopes; D041981:Gastrointestinal Tract / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D049268:Positron-Emission Tomography / Q000379:methods; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000379:methods; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014566:Urogenital System / Q000528:radiation effects
chemical_list: D005462:Fluorine Radioisotopes; C516370:fluoromethylcholine; D017430:Prostate-Specific Antigen; D002794:Choline