Prognostic Value of [ 18 F]-Fluoromethylcholine Positron Emission Tomography/Computed Tomography Before Stereotactic Body Radiation Therapy for Oligometastatic Prostate Cancer

Cysouw, Matthijs C.F.; Bouman-Wammes, Esther W.; Hoekstra, Otto S.; Eertwegh, Alfons J.M. van den; Piet, Maartje; Moorselaar, Jeroen van; Boellaard, Ronald; Dahele, Max; Oprea-Lager, Daniela E.

doi:10.1016/j.ijrobp.2018.02.005

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…Whether the number of metastases also has prognostic value within the collective of oligometastatic patients remains unclear. While some studies -possibly underpowered due to small patient cohorts -could not show any influence, the number of metastases had an impact on the outcome in other studies [6][7][8][9][10][11][12].…”

Section: Oligometastatic Prostate Cancer and Outcome Of Mdtmentioning

confidence: 96%

Radiotherapy of oligometastatic prostate cancer: a systematic review

et al. 2021

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Background Due to improved imaging sensitivity, the term “oligometastatic” prostate cancer disease is diagnosed more often, leading to an increasing interest in metastasis-directed therapy (MDT). There are two types of radiation based MDT applied when treating oligometastatic disease: (1) stereotactic body radiation therapy (SBRT) generally used for bone metastases; or (2) SBRT for isolated nodal oligometastases combined with prophylactic elective nodal radiotherapy. This review aims to summarize current evidence data, which may shed light on the optimal management of this heterogeneous group of patients. Methods A systematic review of the Medline database through PubMed was performed according to PRISMA guidelines. All relevant studies published up to November 2020 were identified and screened. Fifty-six titles were included. Besides outcome parameters, different prognostic and predictive factors were assessed, including site of metastases, time between primary treatment and MDT, use of systemic therapies, hormone sensitivity, as well as pattern of recurrence. Findings Evidence consists largely of retrospective case series and no consistent precise definition of oligometastasis exists, however, most investigators seem to acknowledge the need to distinguish between patients presenting with what is frequently called “synchronous” versus “metachronous” oligometastatic disease. Available data on radiotherapy as MDT demonstrate high local control rates and a small but relevant proportion of patients without progressive disease after 2 years. This holds true for both hormone sensitive and castration resistant prostate cancer diseases. The use of 68Ga-PSMA PET/CT for staging increased dramatically. Radiation doses and field sizes varied considerably among the studies. The search for relevant prognostic and predictive factors is ongoing. Conclusions To our best knowledge this review on oligometastatic prostate cancer included the largest number of original articles. It demonstrates the therapeutic potential and challenges of MDT for oligometastatic prostate cancer. Prospective studies are under way and will provide further high-level evidence.

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Section: Oligometastatic Prostate Cancer and Outcome Of Mdtmentioning

confidence: 96%

Radiotherapy of oligometastatic prostate cancer: a systematic review

et al. 2021

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“…In more recent years, 18F-Fluoromethylcholine has been used for directing SABR to prostate cancer metastase, with some prognostic value [19]. Prostate specific membrane antigen (PSMA) PET scanning has however become the scanning modality of choice for prostate cancer in the metastatic setting [20].…”

Section: Discussionmentioning

confidence: 99%

NaF PET/CT for response assessment of prostate cancer bone metastases treated with single fraction stereotactic ablative body radiotherapy

et al. 2019

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Introduction In prostate cancer patients, imaging of bone metastases is enhanced through the use of sodium fluoride positron emission tomography ( 18 F-NaF PET/CT). This imaging technique shows areas of enhanced osteoblastic activity and blood flow. In this work, 18 F-NaF PET/CT was investigated for response assessment to single fraction stereotactic ablative body radiotherapy (SABR) to bone metastases in prostate cancer patients. Methods Patients with bone metastases in a prospective trial treated with single fraction SABR received a 18 F-NaF PET/CT scan prior to and 6 months post-SABR. The SUV max in the tumour was determined and the difference between before and after SABR determined. The change in uptake in the non-tumour bone was also measured as a function of the received SABR dose. Results Reduction in SUV max was observed in 29 of 33 lesions 6 months after SABR (mean absolute decrease in SUV max 17.7, 95% CI 25.8 to − 9.4, p = 0.0001). Of the three lesions with increased SUV max post-SABR, two were from the same patient and located in the vertebral column. Both were determined to be local progression in addition to one fracture. The third lesion (in a rib) was shown to be controlled locally but suffered from a fracture at 24 months. Progression adjacent to the treated volume was observed in two patients. The non-tumour bone irradiated showed increased loss in uptake with increasing dose, with a median loss in uptake of 23.3% for bone receiving 24 Gy. Conclusion 18 F-NaF PET/CT for response assessment of bone metastases to single fraction SABR indicates high rates of reduction of osteoblastic activity in the tumour and non-tumour bone receiving high doses. The occurrence of marginal recurrence indicates use of larger clinical target volumes may be warranted in treatment of bone metastases. Trial registration POPSTAR, ‘Pilot Study of patients with Oligometastases from Prostate cancer treated with STereotactic Ablative Radiotherapy’, Universal Trial Number U1111-1140-7563 , Registered 17th April 2013. Electronic supplementary material The online version of this article (10.1186/s13014-019-1359-0) contains supplementary material, which is available to authorized users.

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“…7 Ongoing prospective studies have taken similarly disparate approaches to defining oligometastasis with 12 of 20 (60%), 3 of 20 (15%), and 5 of 20 (25%) with available information using cutoffs of ≤5, ≤4, and ≤3 metastases for inclusion, respectively. Additional stipulations have focused on sites of involvement, including lesions in only 1 or 2 organs, 15,71 exclusive lymph node involvement, [19][20][21][22][23]28,30,39,40,45,70 or the exclusion of intracranial disease. 7,69,71 Whether prostatic oligometastases are defined optimally by the number and/or location of lesions and which number and locations are most suitable to select for patients with limited metastatic potential have yet to be determined.…”

Section: Defining Oligometastases: Clinical and Biologic Factorsmentioning

confidence: 99%

“…Most commonly, patients with oligorecurrence or de novo oligometastatic disease have been identified using a specific cutoff for the number of distant sites involved. A list of previously published literature with associated oligometastatic definitions is displayed in Table , with similar definitions used by ongoing, prospective investigations listed in Table . Of 25 retrospective reviews that included >1 case, 10 (40%) used a definition of ≤5 metastases, 3 (12%) used a definition of ≤4 metastases, and 12 (48%) used a definition of ≤3 metastases to define patients with oligometastases in the recurrent or de novo setting.…”

Section: Defining Oligometastases: Clinical and Biologic Factorsmentioning

confidence: 99%

Oligometastatic prostate cancer: Reality or figment of imagination?

Foster

Weichselbaum

Pitroda

2018

Cancer

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The term “oligometastatic prostate cancer” refers to a heterogeneous group of disease states currently defined solely on the basis of clinical features. Oligorecurrent disease, de novo oligometastases, and oligoprogressive disease likely have unique biologic underpinnings and natural histories. Evidence suggesting the existence of a subset of patients who harbor prostate cancer with limited metastatic potential currently includes disparate and overwhelmingly retrospective reports. Nevertheless, emerging prospective data have corroborated the “better‐than‐expected,” retrospectively observed outcomes, particularly in the setting of oligorecurrent prostate cancer. Improved functional imaging with prostate‐specific membrane antigen‐targeted strategies may enhance the identification of patients with oligometastatic prostate cancer in the short term. In the long term, refinement of the oligometastatic case definition likely will require biologic risk‐stratification schemes. To determine optimal treatment strategies and identify patients most likely to benefit from metastasis‐directed therapy, future efforts should focus on conducting high‐quality, prospective trials with much‐needed molecular correlative studies.

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Prognostic Value of [ 18 F]-Fluoromethylcholine Positron Emission Tomography/Computed Tomography Before Stereotactic Body Radiation Therapy for Oligometastatic Prostate Cancer

Cited by 12 publications

References 24 publications

Radiotherapy of oligometastatic prostate cancer: a systematic review

Radiotherapy of oligometastatic prostate cancer: a systematic review

NaF PET/CT for response assessment of prostate cancer bone metastases treated with single fraction stereotactic ablative body radiotherapy

Oligometastatic prostate cancer: Reality or figment of imagination?

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