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Vogel, M.M. ; Dewes, S.* ; Sage, E.K.* ; Devecka, M.* ; Gschwend, J.E.* ; Eiber, M.* ; Combs, S.E. ; Schiller, K.*

A survey among German-speaking radiation oncologists on PET-based radiotherapy of prostate cancer.

Radiat. Oncol. 16:82 (2021)
Publ. Version/Full Text Research data DOI
Open Access Gold
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BACKGROUND: Positron emission tomography-(PET) has evolved as a powerful tool to guide treatment for prostate cancer (PC). The aim of this survey was to evaluate the acceptance and use of PET-especially with prostate-specific membrane antigen (PSMA) targeting tracers-in clinical routine for radiotherapy (RT) and the impact on target volume definition and dose prescription. METHODS: We developed an online survey, which we distributed via e-mail to members of the German Society of Radiation Oncology (DEGRO). The survey included questions on patterns of care of RT for PC with/without PET. For evaluation of doses we used the equivalent dose at fractionation of 2 Gy with α/β = 1.5 Gy [EQD2(1.5 Gy)]. RESULTS: From 109 participants, 78.9% have the possibility to use PET for RT planning. Most centers use PSMA-targeting tracers (98.8%). In 39.5%, PSMA-PET for biochemical relapse after prior surgery is initiated at PSA ≥ 0.5 ng/mL, while 30.2% will perform PET at ≥ 0.2 ng/mL (≥ 1.0 ng/mL: 16.3%, ≥ 2.0 ng/mL: 2.3%, regardless of PSA: 11.7%). In case of PET-positive local recurrence (LR) and pelvic lymph nodes (LNs), 97.7% and 96.5% of the participants will apply an escalated dose. The median total dose in EQD2(1.5 Gy) was 70.00 Gy (range: 56.89-85.71) for LR and 62.00 Gy (range: 52.61-80.00) for LNs. A total number of ≤ 3 (22.0%) or ≤ 5 (20.2%) distant lesions was most often described as applicable for the definition as oligometastatic PC. CONCLUSION: PSMA-PET is widely used among German radiation oncologists. However, specific implications on treatment planning differ among physicians. Therefore, further trials and guidelines for PET-based RT are warranted.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Psma-pet ; Prostate Cancer ; Radiotherapy ; Survey; Metastasis-directed Therapy; Salvage Radiotherapy; Body Radiotherapy; Psma Pet/ct; Recurrence; Guidelines; Surveillance; Progression; Diagnosis
ISSN (print) / ISBN 1748-717X
e-ISSN 1748-717X
Quellenangaben Volume: 16, Issue: 1, Pages: , Article Number: 82 Supplement: ,
Publisher BioMed Central
Publishing Place Campus, 4 Crinan St, London N1 9xw, England
Reviewing status Peer reviewed
Grants Projekt DEAL