Influence of (11)C-choline PET/CT on the treatment planning for salvage radiation therapy in patients with biochemical recurrence of prostate cancer

Radiother Oncol. 2011 May;99(2):193-200. doi: 10.1016/j.radonc.2011.05.005. Epub 2011 May 26.

Abstract

Background and purpose: The present study evaluates the incidence of (11)C-choline PET/CT positive findings in patients with recurrent prostate cancer referred for salvage radiotherapy (SRT) and the influence on the definition of the planning target volume (PTV).

Material and methods: Thirty-seven patients treated with radical prostatectomy and referred to SRT to the prostatic fossa because of biochemical relapse, were analysed retrospectively. All patients underwent (11)C-choline PET/CT before radiotherapy. The influence of PET/CT on the extent of the PTV was analysed. The median total follow up after SRT was 51.2 months.

Results: 11/37 (30%) patients had a positive finding in the (11)C-choline PET/CT, 5 (13%) outside of the prostatic fossa (iliac lymph nodes), implicating an extension of the PTV. Patients with positive (11)C-choline PET/CT had a significant higher PSA value than patients with no pathologic uptake (p=0.03). Overall, at the end of follow up 56% of the patients had a PSA ≤ 0.2ng/ml and 44% had a biochemical relapse of prostate cancer.

Conclusions: (11)C-choline PET/CT detects abnormalities outside of the prostatic fossa in 13% of patients referred for SRT because of biochemical relapse after radical prostatectomy, affecting the extent of the PTV. Prospective studies need to be implemented to evaluate the benefit of SRT with a PTV based on (11)C-choline PET/CT.

MeSH terms

  • Aged
  • Carbon Radioisotopes
  • Choline*
  • Humans
  • Logistic Models
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Neoplasm Recurrence, Local / radiotherapy*
  • Neoplasm Staging
  • Positron-Emission Tomography / methods*
  • Predictive Value of Tests
  • Prostate-Specific Antigen / blood
  • Prostatectomy
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / radiotherapy*
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiotherapy Planning, Computer-Assisted
  • Retrospective Studies
  • Salvage Therapy
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods*

Substances

  • Carbon Radioisotopes
  • Prostate-Specific Antigen
  • Choline