Background And Purpose: We investigated the role of Ga-PSMA-PET (PSMA) to determine the location of disease recurrence in those with a rising PSA following definitive external beam radiation treatment (EBRT).

Materials And Methods: 538men were treated with image guided EBRT to a dose of 78 or 82Gy between 2007 and 2014. Patients at least 24months post EBRT with biochemical failure (nadir+2) underwent PSMA scanning. Local recurrence (LR) was defined as increased uptake within the prostate or seminal vesicles. Distant disease included lymph node (LN), bone or visceral metastases.

Results: 419men formed the study cohort. Median follow-up was 50months, 70 patients (17%) had biochemical failure (BF), 13 of whom have died. Of the 57 survivors, 5 had metastases detected on conventional scans; 2 were lost to follow up. 48men (of 50 candidates) underwent PSMA; in all cases, the PSMA was unequivocally positive. Of the 48 positive scans, 25 patients (52%) failed beyond the prostate - 5 in bones, 16LN, 3 in both, and 1 in the lungs. Fifteen men (31%) failed within the gland and in either LN (11), bones (3), or both (1). Eight (17%) had an isolated LR, which represents 2% of patients managed with definitive EBRT and followed for at least 2years.

Conclusions: PSMA was positive in all patients with BF. Site of failure following dose-escalated EBRT was generally distant. Isolated LR (on PSMA) occurred in only 8 of 419 patients post-EBRT.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.radonc.2016.11.023DOI Listing

Publication Analysis

Top Keywords

biochemical failure
12
definitive external
8
external beam
8
beam radiation
8
radiation treatment
8
underwent psma
8
psma
6
patients
6
delineating biochemical
4
failure
4

Similar Publications

Background: Immune checkpoint inhibitors (ICIs) are effective antineoplastic agents but can cause adverse effects in many organ systems. Cardiovascular toxicities include arrhythmias, myocarditis, heart failure, takotsubo syndrome, pericarditis, coronary artery disease, and vasculitis.

Case Summary: A 66-year-old woman with Stage 3C2 endometrial carcinoma presented for her second cycle of pembrolizumab, carboplatin, and paclitaxel.

View Article and Find Full Text PDF

Background: Men with pathogenic BRCA1/2 variants are at higher risk of prostate cancer We included men with likely pathogenic/pathogenic (LP/P) variants in BRCA1/2 in a prostate-specific antigen (PSA) screening program after cascade germline testing since 2014. PSA was tested yearly and an age-specific low PSA threshold for biopsy was used, to determine if a low PSA threshold for biopsy is justified for men with pathogenic BRCA1/2 variants.

Methods: From 2014 to 2023 a total of 340 men were included in the program.

View Article and Find Full Text PDF

This article provides a comprehensive overview of the current treatment options for patients with metastatic castration-resistant prostate cancer (mCRPC) following the failure of first-line therapy. Although significant progress has been made in the primary treatment of hormone-sensitive prostate cancer, the management of mCRPC remains a clinical challenge. The article outlines the diagnostic criteria for mCRPC, which can be confirmed through biochemical progression and imaging techniques.

View Article and Find Full Text PDF

Acute coronary syndrome (ACS) remains a major global health burden, encompassing a spectrum of conditions from unstable angina to acute myocardial infarction. Despite advancements in early detection and management, ACS is often complicated by the development of heart failure. This systematic review and meta-analysis aimed to identify factors associated with the development of heart failure following acute coronary syndrome.

View Article and Find Full Text PDF

The role of the extracellular matrix in cardiac regeneration.

Heliyon

January 2025

Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

The extracellular matrix (ECM) is a complex and dynamic three-dimensional network that functions as an architectural scaffold to maintain cardiac homeostasis. Important biochemical and mechanical signals associated with cell‒cell communication are provided via the reciprocal interaction between cells and the ECM. By converting mechanical cues into biochemical signals, the ECM regulates many cell processes, including migration, adhesion, growth, differentiation, proliferation, and apoptosis.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!