A new study by Denmark shows for the first time that men with biochemically recurring prostate cancer who undergo a PSMA PET / TDM before rescue radiotherapy improved survival rates compared to those who do not.
Using data collected nationally over a period of eight years, researchers have confirmed that PSMA PET / CT is a precious tool to identify patients likely to benefit from recovery radiotherapy. This research was published in the August issue of Le Journal of Nuclear Medicine.
Biochemical recurrence after radical prostatectomy occurs in up to 40% of prostate cancer patients and rescue radiotherapy is recommended as the main curative option. With recovery radiotherapy, doctors rely on imaging to locate recurrences for a targeted treatment with precision. Although this imagery was previously carried out with bone scintigraphy, CT or MRI, the excellent diagnostic capacity of PSMA PET / CT makes it the current modality of choice.
It is widely accepted that PSMA PET / CT is more precise than other imaging methods to return prostate cancer, and that it often modifies patient treatment strategies, said Anna W. Mogensen, MSC, doctoral student in the Aalborg University Hospital Nuclear Department in Aalborg, Denmark. However, it remained clear if the changes guided by the PSMA TEP / CT in the treatment strategy led to an improvement in survival.
She continued, PSMA PET / CT was introduced in Denmark in 2015; However, not all regions have adopted the imagery modality at a time. Using the health register at the national level of Denmark, my colleagues and I have compiled an important and complete data set to compare the overall survival between the patients who underwent a PSMA PET / CT before recovery radiotherapy and those who did not do so.
The study used data obtained from the clinical routine practice of all patients treated with recovery radiotherapy in Denmark from 2015 to 2023. In total, 844 patients were classified according to whether they had undergone PSMA PET / CT pre -treatment (308 patients) or not (536 patients). The researchers compared overall survival, as well as biochemical survival without recurrence, up to five years after the end of recovery radiotherapy.
The analysis revealed a greater overall survival for patients who have undergone a PSMA TEP / TDM before recovery radiotherapy than for patients who did not do so. The survival rates at one, two and five years for PSMA PET / CT patients were respectively 100, 99.5 and 98.1%, against 99, 97.8 and 93.8%, respectively, for PET / TDM patients.
The three -year biochemical reoffending survival rate was in accordance with overall survival: 74.9% for PSMA PET / CT patients and 69.4% for non -PSMA PET / TDM patients.
Our results show that PSMA PET / TDM scanners can help clinicians select patients most likely to succeed with recovery radiotherapy. This means that fewer patients can receive unnecessary treatment, while more will receive appropriate care, said Moogensen. These results support a broader use of nuclear medicine techniques to guide therapy and suggest that the integration of imaging at the start of processing decisions could become a new standard in cancer care.