PURPOSE: To assess usefulness of (18F)-fluorocholine positron emission tomography (PET) for localizing relapse in patients with biochemical relapse from prostate adenocarcinoma and its impact on indications of salvage local therapy.
PATIENTS AND METHODS: An (18F)-fluorocholine PET coupled with computed tomography was performed in 28 patients with biochemical progression from prostate adenocarcinoma. At the time of (18F)-fluorocholine PET, median prostate specific antigen (PSA) was 3.0ng/mL (from 0.34 to 93ng/mL) and 17 patients (60.7%) received hormone therapy. Eighteen patients from this cohort were potentially candidates to salvage radiotherapy.
RESULTS: A pathologic uptake was shown in 11 patients (39.3%) and 17 patients (60.7%) had no pathologic uptake. Median PSA was 2.4ng/mL (0.33 to 36ng/mL) in case of negative (18F)-fluorocholine PET, versus 6.75ng/mL (1.21 to 93ng/mL) in case of pathologic uptake (P=0.04). Among the 17 patients candidates to salvage radiotherapy, (18F)-fluorocholine PET helped deciding for salvage radiotherapy in five patients, since it showed only centropelvic pathologic uptake (27.7%). In one patient, it showed metastatic and radiotherapy was contraindicated. After prostatectomy, (18F)-fluorocholine PET was positive in only one patient candidate to salvage radiotherapy (9.1%), showing anastomotic relapse.
CONCLUSION: (18F)-fluorocholine was positive in about a third of patients with biochemical progression. Its clinical impact is being prospectively investigated.
Written by:
Moussaid Y, Bonardel G, Jacob J, Métivier D, Gontier E, Bauduceau O, Durand X, Fayolle M, Houlgatte A, Foehrenbach H, Védrine L, Chargari C. Are you the author?
Service d'oncologie radiothérapie, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France; Institut national d'oncologie, Rabat, Maroc.
Reference: Cancer Radiother. 2013 May 20. pii: S1278-3218(13)00055-3.
doi: 10.1016/j.canrad.2013.01.019
PubMed Abstract
PMID: 23702489
Article in French.
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