Efficacy of Eradicative Radiotherapy for Limited Nodal Metastases Detected with Choline PET Scan in Prostate Cancer Patients

Abstract

Stereotactic body radiotherapy was effective in disease eradication of limited nodal recurrences from prostate cancer, saving patients from, or at least postponing, systemic treatments.

18F-fluorocholine for prostate cancer imaging: a systematic review of the literature

“…Seven studies detailing the radiosynthesis of 18 F-FCH, preclinical and early clinical dosimetry and biodistribution in humans were identified. [20][21][22][23][24][25][26] Clinical studies included six articles for evaluation of local disease, [27][28][29][30][31][32] five articles for evaluation of nodal disease, 30,[33][34][35][36] six articles for bone metastases, including evaluation of treatment response, 30,34,[37][38][39][40] 12 articles for biochemical recurrence 34,[36][37][38][40][41][42][43][44][45][46][47] and two articles evaluating 18 F-FCH in castrate-resistant patients. 39,48 Seven studies evaluated 18 F-FCH for defining intra-prostatic lesions or limited lymph node recurrence for dose-escalated radiotherapy.…”

“…39,48 Seven studies evaluated 18 F-FCH for defining intra-prostatic lesions or limited lymph node recurrence for dose-escalated radiotherapy. 47,[49][50][51][52][53][54] Two clinical studies evaluated the physiological distribution and false-positive 18 F-FCH uptakes. 55,56 The literature data on 18 F-FCH prostate cancer imaging are summarized in Table 1.…”

“…20,21,24,34,35,37,38,42,57 Early time points for imaging (0-15 min post-intravenous injection) and/or delayed imaging time points (30,40,45,60, 90-120 and 65-200 min post-intravenous injection) have been also described in the published literature. 22,23,[27][28][29][30][31][32][33]36,39,40,41,[43][44][45][46][47][48][49][50][51][52][54][55][56] 34 16…”

“…McCarthy et al 48 26 Poulsen et al 33 25 Casamassima et al 47 71 Roef et al 55 10 Langsteger et al 40 42 a…”

“…In the setting of biochemical recurrence, generally the performance of 18 F-FCH PET/CT seems to be higher among patients with higher PSA at the time of recurrence, shorter PSA doubling time or higher initial Gleason grade. 34,[36][37][38][41][42][43][44][45][46][47] For instance, Cimitan et al 41 found positive 18 F-FCH scans in 54 patients examined for rising PSA post-radical prostatectomy (n ¼ 58), radical radiotherapy (n ¼ 21) or while on hormones (n ¼ 21). They noted that the 18 F-FCH scans were rarely (3/38) positive among patients with PSA o4 ng ml À1 and initial Gleason grade p7, whereas all patients with a PSA 44 ng ml À1 and Gleason score 47 had positive scans.…”