Prostate-specific membrane antigen positron emission tomography detected local failure after post-prostatectomy radiation therapy: Low rates of out-of-field recurrence validates current Australian prostate bed contouring guidelines
The Australian Faculty of Radiation Oncology Genitourinary Group (FROGG) developed prostate bed clinical target volume (CTV) contouring guidelines which were subsequently used to develop the National EviQ guidelines for adjuvant and salvage post-prostatectomy radiotherapy (PPRT). These guidelines we...
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Veröffentlicht in: | Journal of medical imaging and radiation oncology 2023-09, Vol.67 (6), p.662-667 |
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creator | Shakespeare, Thomas Philip Yap, Shaun Zheng Liang Hsieh, Michael Tahir, Abdul Rahim Mohd Armstrong, Shreya |
description | The Australian Faculty of Radiation Oncology Genitourinary Group (FROGG) developed prostate bed clinical target volume (CTV) contouring guidelines which were subsequently used to develop the National EviQ guidelines for adjuvant and salvage post-prostatectomy radiotherapy (PPRT). These guidelines were based mainly upon consensus agreement. With the advent of prostate-specific membrane antigen (PSMA) positron emission tomography (PET), sites of recurrence can now be detected with low prostate-specific antigen (PSA) levels following radical prostatectomy. We evaluated sites of recurrence in patients treated with FROGG/EviQ CTVs to inform upcoming modifications of these guidelines.
At our institution, we use the FROGG/EviQ guidelines for PPRT. From 2015, patients with PSA failure following PPRT have been re-staged using PSMA PET imaging. We identified patients with PET-avid local, nodal, and distant recurrences, fusing them with original treatment plans to determine whether recurrences were within or outside the prostate bed CTV. Regional nodal failures were reviewed to determine if they were within current elective node contouring guidelines.
Ninety-four patients had positive PSMA PET following PPRT. Nine (9.6%) recurrences were local, seven being local-only. One local recurrence (1.1%) was just superior to the contoured prostate bed CTV, located within the vas deferens. Seventy-three (77.7%) patients had a component of node failure, with 56 (59.6%) having node-only failure. Sites of nodal relapses were covered by standard contouring guidelines 60.3% of the time.
The low recurrence rate outside of current prostate bed CTV contouring guidelines is consistent with other studies using contemporary contouring, and validates the efficacy of the current FROGG/EviQ prostate bed CTV definition. |
doi_str_mv | 10.1111/1754-9485.13556 |
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At our institution, we use the FROGG/EviQ guidelines for PPRT. From 2015, patients with PSA failure following PPRT have been re-staged using PSMA PET imaging. We identified patients with PET-avid local, nodal, and distant recurrences, fusing them with original treatment plans to determine whether recurrences were within or outside the prostate bed CTV. Regional nodal failures were reviewed to determine if they were within current elective node contouring guidelines.
Ninety-four patients had positive PSMA PET following PPRT. Nine (9.6%) recurrences were local, seven being local-only. One local recurrence (1.1%) was just superior to the contoured prostate bed CTV, located within the vas deferens. Seventy-three (77.7%) patients had a component of node failure, with 56 (59.6%) having node-only failure. Sites of nodal relapses were covered by standard contouring guidelines 60.3% of the time.
The low recurrence rate outside of current prostate bed CTV contouring guidelines is consistent with other studies using contemporary contouring, and validates the efficacy of the current FROGG/EviQ prostate bed CTV definition.</description><identifier>ISSN: 1754-9477</identifier><identifier>EISSN: 1754-9485</identifier><identifier>DOI: 10.1111/1754-9485.13556</identifier><identifier>PMID: 37401187</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Antigens ; Contouring ; Failure ; Guidelines ; Membranes ; Nodes ; Positron emission ; Prostate ; Radiation ; Radiation therapy ; Tomography ; Urological surgery</subject><ispartof>Journal of medical imaging and radiation oncology, 2023-09, Vol.67 (6), p.662-667</ispartof><rights>2023 The Royal Australian and New Zealand College of Radiologists.</rights><rights>Copyright © 2023 The Royal Australian and New Zealand College of Radiologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c325t-3f1982f423dd1934392377f77464a230709dae145eda53455936c9882eed75363</citedby><cites>FETCH-LOGICAL-c325t-3f1982f423dd1934392377f77464a230709dae145eda53455936c9882eed75363</cites><orcidid>0000-0002-6859-6977</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37401187$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shakespeare, Thomas Philip</creatorcontrib><creatorcontrib>Yap, Shaun Zheng Liang</creatorcontrib><creatorcontrib>Hsieh, Michael</creatorcontrib><creatorcontrib>Tahir, Abdul Rahim Mohd</creatorcontrib><creatorcontrib>Armstrong, Shreya</creatorcontrib><title>Prostate-specific membrane antigen positron emission tomography detected local failure after post-prostatectomy radiation therapy: Low rates of out-of-field recurrence validates current Australian prostate bed contouring guidelines</title><title>Journal of medical imaging and radiation oncology</title><addtitle>J Med Imaging Radiat Oncol</addtitle><description>The Australian Faculty of Radiation Oncology Genitourinary Group (FROGG) developed prostate bed clinical target volume (CTV) contouring guidelines which were subsequently used to develop the National EviQ guidelines for adjuvant and salvage post-prostatectomy radiotherapy (PPRT). These guidelines were based mainly upon consensus agreement. With the advent of prostate-specific membrane antigen (PSMA) positron emission tomography (PET), sites of recurrence can now be detected with low prostate-specific antigen (PSA) levels following radical prostatectomy. We evaluated sites of recurrence in patients treated with FROGG/EviQ CTVs to inform upcoming modifications of these guidelines.
At our institution, we use the FROGG/EviQ guidelines for PPRT. From 2015, patients with PSA failure following PPRT have been re-staged using PSMA PET imaging. We identified patients with PET-avid local, nodal, and distant recurrences, fusing them with original treatment plans to determine whether recurrences were within or outside the prostate bed CTV. Regional nodal failures were reviewed to determine if they were within current elective node contouring guidelines.
Ninety-four patients had positive PSMA PET following PPRT. Nine (9.6%) recurrences were local, seven being local-only. One local recurrence (1.1%) was just superior to the contoured prostate bed CTV, located within the vas deferens. Seventy-three (77.7%) patients had a component of node failure, with 56 (59.6%) having node-only failure. Sites of nodal relapses were covered by standard contouring guidelines 60.3% of the time.
The low recurrence rate outside of current prostate bed CTV contouring guidelines is consistent with other studies using contemporary contouring, and validates the efficacy of the current FROGG/EviQ prostate bed CTV definition.</description><subject>Antigens</subject><subject>Contouring</subject><subject>Failure</subject><subject>Guidelines</subject><subject>Membranes</subject><subject>Nodes</subject><subject>Positron emission</subject><subject>Prostate</subject><subject>Radiation</subject><subject>Radiation therapy</subject><subject>Tomography</subject><subject>Urological surgery</subject><issn>1754-9477</issn><issn>1754-9485</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpdUk1v1DAQjRCIlsKZG7LEhUtaO7bjhFtV0YK0Ujm058hrj7eunDjYDmh_MX-D2Q_2UF9sPb335nlmquojo5cMzxVTUtS96OQl41K2r6rzE_L69FbqrHqX8zOlLWOif1udcSUoY506r_7-TDEXXaDOMxjvvCEjjOukJyB6Kn4DE5lj9iXFicDoc_b4KHGMm6Tnpy2xUMAUsCREowNx2oclodYVSDtlqedjBYOqLUnael32Jk-AFtuvZBX_IFwgk-hIXEodXe08BEsSmCUlmAyQ3zp4uycdoEKul1wSohoTHkuQNQYxcSpxSX7akM3iLQQ_QX5fvXE6ZPhwvC-qx9tvDzff69X93Y-b61VteCNLzR3ru8aJhlvLei5433ClnFKiFbrhVNHeamBCgtWSCyl73pq-6xoAqyRv-UX15eCLkX4tkMuAPTMQAjY0LnloOs5pI1UnkPr5BfUZY0-YDlltizkolci6OrAM_jEncMOc_KjTdmB02O3AsJvysJv4sN8BVHw6-i7rEeyJ_3_o_B-jA7KJ</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Shakespeare, Thomas Philip</creator><creator>Yap, Shaun Zheng Liang</creator><creator>Hsieh, Michael</creator><creator>Tahir, Abdul Rahim Mohd</creator><creator>Armstrong, Shreya</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6859-6977</orcidid></search><sort><creationdate>20230901</creationdate><title>Prostate-specific membrane antigen positron emission tomography detected local failure after post-prostatectomy radiation therapy: Low rates of out-of-field recurrence validates current Australian prostate bed contouring guidelines</title><author>Shakespeare, Thomas Philip ; Yap, Shaun Zheng Liang ; Hsieh, Michael ; Tahir, Abdul Rahim Mohd ; Armstrong, Shreya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c325t-3f1982f423dd1934392377f77464a230709dae145eda53455936c9882eed75363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antigens</topic><topic>Contouring</topic><topic>Failure</topic><topic>Guidelines</topic><topic>Membranes</topic><topic>Nodes</topic><topic>Positron emission</topic><topic>Prostate</topic><topic>Radiation</topic><topic>Radiation therapy</topic><topic>Tomography</topic><topic>Urological surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shakespeare, Thomas Philip</creatorcontrib><creatorcontrib>Yap, Shaun Zheng Liang</creatorcontrib><creatorcontrib>Hsieh, Michael</creatorcontrib><creatorcontrib>Tahir, Abdul Rahim Mohd</creatorcontrib><creatorcontrib>Armstrong, Shreya</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of medical imaging and radiation oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shakespeare, Thomas Philip</au><au>Yap, Shaun Zheng Liang</au><au>Hsieh, Michael</au><au>Tahir, Abdul Rahim Mohd</au><au>Armstrong, Shreya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prostate-specific membrane antigen positron emission tomography detected local failure after post-prostatectomy radiation therapy: Low rates of out-of-field recurrence validates current Australian prostate bed contouring guidelines</atitle><jtitle>Journal of medical imaging and radiation oncology</jtitle><addtitle>J Med Imaging Radiat Oncol</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>67</volume><issue>6</issue><spage>662</spage><epage>667</epage><pages>662-667</pages><issn>1754-9477</issn><eissn>1754-9485</eissn><abstract>The Australian Faculty of Radiation Oncology Genitourinary Group (FROGG) developed prostate bed clinical target volume (CTV) contouring guidelines which were subsequently used to develop the National EviQ guidelines for adjuvant and salvage post-prostatectomy radiotherapy (PPRT). These guidelines were based mainly upon consensus agreement. With the advent of prostate-specific membrane antigen (PSMA) positron emission tomography (PET), sites of recurrence can now be detected with low prostate-specific antigen (PSA) levels following radical prostatectomy. We evaluated sites of recurrence in patients treated with FROGG/EviQ CTVs to inform upcoming modifications of these guidelines.
At our institution, we use the FROGG/EviQ guidelines for PPRT. From 2015, patients with PSA failure following PPRT have been re-staged using PSMA PET imaging. We identified patients with PET-avid local, nodal, and distant recurrences, fusing them with original treatment plans to determine whether recurrences were within or outside the prostate bed CTV. Regional nodal failures were reviewed to determine if they were within current elective node contouring guidelines.
Ninety-four patients had positive PSMA PET following PPRT. Nine (9.6%) recurrences were local, seven being local-only. One local recurrence (1.1%) was just superior to the contoured prostate bed CTV, located within the vas deferens. Seventy-three (77.7%) patients had a component of node failure, with 56 (59.6%) having node-only failure. Sites of nodal relapses were covered by standard contouring guidelines 60.3% of the time.
The low recurrence rate outside of current prostate bed CTV contouring guidelines is consistent with other studies using contemporary contouring, and validates the efficacy of the current FROGG/EviQ prostate bed CTV definition.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37401187</pmid><doi>10.1111/1754-9485.13556</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-6859-6977</orcidid></addata></record> |
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subjects | Antigens Contouring Failure Guidelines Membranes Nodes Positron emission Prostate Radiation Radiation therapy Tomography Urological surgery |
title | Prostate-specific membrane antigen positron emission tomography detected local failure after post-prostatectomy radiation therapy: Low rates of out-of-field recurrence validates current Australian prostate bed contouring guidelines |
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