Adjuvant radiotherapy after salvage lymph node dissection because of nodal relapse of prostate cancer versus salvage lymph node dissection only

Rischke, Hans Christian; Schultze-Seemann, Wolfgang; Wieser, Gesche; Krönig, Malte; Drendel, Vanessa; Stegmaier, Petra; Krauß, Tobias; Henne, Karl; Volegova-Neher, Natalia; Schlager, Daniel; Kirste, Simon; Grosu, Anca‐Ligia; Jilg, Cordula A.

doi:10.1007/s00066-014-0763-5

Cited by 95 publications

(56 citation statements)

References 33 publications

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“…Similar, Rischke et al found a significant improvement in 5-year next-relapse-free survival when adjuvant pelvic EBRT was added to salvage PLND (27). In contrast, we observed a local relapse in 7% of our pN1 PC patients compared to 3% in the pN0 population.…”

supporting

confidence: 87%

The Outcome for Patients With Pathologic Node-Positive Prostate Cancer Treated With Intensity Modulated Radiation Therapy and Androgen Deprivation Therapy: A Case-Matched Analysis of pN1 and pN0 Patients

Hemelryk

Meerleer

Ost

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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supporting

confidence: 87%

The Outcome for Patients With Pathologic Node-Positive Prostate Cancer Treated With Intensity Modulated Radiation Therapy and Androgen Deprivation Therapy: A Case-Matched Analysis of pN1 and pN0 Patients

Hemelryk

Meerleer

Ost

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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“…In cases of isolated lymph node metastases, there is also the option to perform a salvage lymph node dissection of the pelvis with [27,28] or without [29] adjuvant radiotherapy. Complications of this surgical metastasis directed approach are bleeding, infection, ileus, hydronephrosis and drainage requiring lymphocele [30].…”

Section: Discussionmentioning

confidence: 99%

68Ga-PSMA ligand PET/CT-based radiotherapy in locally recurrent and recurrent oligometastatic prostate cancer

et al. 2016

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“…There is also the option to perform salvage lymph node dissection of the pelvis with (25,26) or without (27,28) adjuvant radiotherapy, taking into account that adjuvant irradiation results in delayed relapse within the treated region, but has no effect on the relapse pattern outside the treated region. Therefore, the combination of two local treatment modalities within the same anatomic region does not offer any additional benefit for patients with prostate cancer (27).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the combination of two local treatment modalities within the same anatomic region does not offer any additional benefit for patients with prostate cancer (27). In addition, surgery has the risk of common perioperative complications (25)(26)(27)(28). To our knowledge, no prospective studies comparing salvage lymph node dissection with or without radiotherapy using PSMA-PET/CT for staging purposes have been conducted.…”

Section: Discussionmentioning

confidence: 99%

68Ga-PSMA Ligand PET/CT-based Radiotherapy for Lymph Node Relapse of Prostate Cancer After Primary Therapy Delays Initiation of Systemic Therapy

Henkenberens

Klot

Roß

et al. 2017

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Among patients with prostate cancer, tumor relapse after primary therapy particularly occurs in high-risk groups. The standard of care for distant relapse of prostate cancer is androgen-deprivation therapy (ADT), which has a negative impact on the patient's quality of life (1). Recently alternative local treatment strategies have been proposed for patients with oligometastatic disease, who have a better prognosis than patients with extensive disease (2). Local therapies such as radiotherapy could provide effective local control, delay disease progression and therefor reduce the need to initiate systemic therapies (3). The identification of patients with oligometastatic prostate cancer is challenging due to the lack of sufficiently sensitive imaging for detection of low-volume recurrent and metastatic disease in patients with low prostatespecific antigen (PSA) levels (2). In general, positronemission tomography-computed tomography (PET/CT) for radiotherapy has proven helpful in patient selection and target volume delineation, with promising results regarding clinical outcome and toxicity (4, 5). A new diagnostic option in this context is the use of prostate-specific membrane antigen (PSMA) ligands for PET/CT. 68 Ga-PSMA ligand PET/CT has been reported to have a substantially higher diagnostic accuracy for the detection of prostate cancer metastases than choline-based PET/CT, particularly in the case of lymph node metastases (6-10). Data on the effectiveness of 68 Ga-PSMA ligand PET/CT-based radiotherapy for prostate cancer lymph node metastases after primary therapy are limited.The aim of the present study was to assess the clinical outcome and time of initiation of systemic therapies (ADT or chemotherapy) of patients with isolated prostate cancer lymph node metastases after primary therapy treated with 68 Ga-labelled PSMA ligand PET/CT-guided 3D conformal radiotherapy. Patients and MethodsStudy population. Between June 2014 and March 2016, 23 patients with biochemical failure and a PSA above 0.5 ng/ml after primary therapy of prostate cancer underwent 68 Ga-PSMA ligand PET/CT for restaging purposes and were treated with radiotherapy of the 68 Ga-PSMA ligand PET/CT-positive lymph nodes. All cases were discussed 1273

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Adjuvant radiotherapy after salvage lymph node dissection because of nodal relapse of prostate cancer versus salvage lymph node dissection only

Abstract: ART after salvage-LND provides stable local control in TR and results in overall significant improved next-relapse-free survival, compared to patients who received surgery only in case of nodal PCa-relapse.

Cited by 95 publications

References 33 publications

The Outcome for Patients With Pathologic Node-Positive Prostate Cancer Treated With Intensity Modulated Radiation Therapy and Androgen Deprivation Therapy: A Case-Matched Analysis of pN1 and pN0 Patients

The Outcome for Patients With Pathologic Node-Positive Prostate Cancer Treated With Intensity Modulated Radiation Therapy and Androgen Deprivation Therapy: A Case-Matched Analysis of pN1 and pN0 Patients

68Ga-PSMA ligand PET/CT-based radiotherapy in locally recurrent and recurrent oligometastatic prostate cancer

68Ga-PSMA Ligand PET/CT-based Radiotherapy for Lymph Node Relapse of Prostate Cancer After Primary Therapy Delays Initiation of Systemic Therapy

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