68Ga-PSMA Ligand PET/CT-based Radiotherapy for Lymph Node Relapse of Prostate Cancer After Primary Therapy Delays Initiation of Systemic Therapy.
To evaluate68Ga-PSMA ligand positron-emission tomography-computed tomography (PET/CT)-based radiotherapy for lymph node metastases of prostate cancer after primary therapy.



Twenty-three patients received radiotherapy for PSMA ligand-positive lymph node metastases.



The median follow-up time was 12.4 (range=6.0-28.5) months. The median pre-treatment prostate-specific antigen (PSA) decreased from 2.75 (range=0.52-8.92) ng/ml to a nadir of 1.37 (range=0.11-8.00) ng/ml (p=0.001) following radiotherapy. Except for one patient (4.4%), PSA level decreased in 22 patients (95.6%). The biochemical failure-free survival and time to initiation of systemic therapy at the median follow-up were 95.6% and 100%, respectively. Three patients (12.9%) presented with recurrent disease outside the initial radiation field. No grade III acute toxicities or late grade II toxicities were observed.



68Ga-PSMA ligand PET/CT-based radiotherapy is a promising local treatment option for isolated lymph node metastases of prostate cancer.
Department of Radiation Oncology, Hannover Medical School, Hannover, Germany henkenberens.christoph@mh-hannover.de.
Christoph
C
Henkenberens
Department of Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany.
Christoph A
CA
VON Klot
Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
Tobias L
TL
Ross
Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
Frank M
FM
Bengel
Pharmaceutical Radiochemistry, Technical University of Munich, Garching, Germany.
Hans-Jürgen
HJ
Wester
Department of Radiology, Hannover Medical School, Hannover, Germany.
Hüper
H
Katja
Department of Radiation Oncology, Hannover Medical School, Hannover, Germany.
Hans
H
Christiansen
Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
Thorsten
T
Derlin
D000368:Aged; D000369:Aged, 80 and over; D000954:Antigens, Surface / Q000737:chemistry; D005710:Gallium Radioisotopes / Q000737:chemistry*; D043425:Glutamate Carboxypeptidase II / Q000737:chemistry; D006801:Humans; D008024:Ligands; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D012008:Recurrence; D061665:Time-to-Treatment; D016896:Treatment Outcome
D000954:Antigens, Surface; D005710:Gallium Radioisotopes; D008024:Ligands; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II; D017430:Prostate-Specific Antigen
PSMA-PET/CT; lymph node metastases; radiotherapy; recurrent prostate cancer; systemic therapy