Objectives: To evaluate the role of 11C-Choline PET/CT as image-guide tool for tomotherapy treatment(HTT)of lymph-node relapses and for treatment monitoring in prostate cancer patients. Methods: 31 prostate cancer pts with biochemical recurrence after primary treatment (mean PSA0:14,12 ng/ml) performed PET/CT0 for restaging and planning treatment.PET/TC0 positive pelvic and abdominal lymph nodes were treated with high dose using simultaneous boost (n=34 treatments).After the end of HTT PSA1 was measured and compared to PSA0 to evaluate biochemical response;in 24/34 pts a PET/CT1 scan was repeated to assess metabolic response.In 25/34 treatments, a further PSA2 measurement was recorded; in 13/25 cases a PET/CT2 was performed.PSA2 and PET/CT2 were compared to the basal ones. Results: PET/CT0 showed 34 sites of nodal involvement (20 pelvic,8 abdominal,6 pelvic+abdominal) that were included in treatment planning.PSA1 (mean 4.55 ng/ml; range 0.00-46.39 ng/ml) showed biochemical response after HTT in 31/34 cases and progression in 3/34 while PSA2 (mean 0.98ng/ml; range 0.00-10.71 ng/ml) in 19/25 and 6/25 treatments respectively. Metabolic response at treated areas at PET/CT1 resulted:complete (CMR) in 11/24, partial (PMR) in 9/24, progression disease (PD) in 2/24 and stable disease (SD) in 2/24. In 4/24 cases distant metastases were detected. PET/CT2 showed CMR in 11/13, PMR in 1/13 and PD in 1/13 on treated areas. Distant metastases occurred in 4/13 cases. Conclusions: 11C-Choline PET/CT is a valuable tool for planning and monitoring HTT treatment on lymph nodal relapse. HTT and concomitant systemic therapy are effective as demonstrated by the good rate of local control.
Helical tomotherapy treatment planning of lymph-node relapses in prostate cancer: Clinical value of 11C-Choline PET/CT
Maria Picchio;Cristina Messa
2012
Abstract
Objectives: To evaluate the role of 11C-Choline PET/CT as image-guide tool for tomotherapy treatment(HTT)of lymph-node relapses and for treatment monitoring in prostate cancer patients. Methods: 31 prostate cancer pts with biochemical recurrence after primary treatment (mean PSA0:14,12 ng/ml) performed PET/CT0 for restaging and planning treatment.PET/TC0 positive pelvic and abdominal lymph nodes were treated with high dose using simultaneous boost (n=34 treatments).After the end of HTT PSA1 was measured and compared to PSA0 to evaluate biochemical response;in 24/34 pts a PET/CT1 scan was repeated to assess metabolic response.In 25/34 treatments, a further PSA2 measurement was recorded; in 13/25 cases a PET/CT2 was performed.PSA2 and PET/CT2 were compared to the basal ones. Results: PET/CT0 showed 34 sites of nodal involvement (20 pelvic,8 abdominal,6 pelvic+abdominal) that were included in treatment planning.PSA1 (mean 4.55 ng/ml; range 0.00-46.39 ng/ml) showed biochemical response after HTT in 31/34 cases and progression in 3/34 while PSA2 (mean 0.98ng/ml; range 0.00-10.71 ng/ml) in 19/25 and 6/25 treatments respectively. Metabolic response at treated areas at PET/CT1 resulted:complete (CMR) in 11/24, partial (PMR) in 9/24, progression disease (PD) in 2/24 and stable disease (SD) in 2/24. In 4/24 cases distant metastases were detected. PET/CT2 showed CMR in 11/13, PMR in 1/13 and PD in 1/13 on treated areas. Distant metastases occurred in 4/13 cases. Conclusions: 11C-Choline PET/CT is a valuable tool for planning and monitoring HTT treatment on lymph nodal relapse. HTT and concomitant systemic therapy are effective as demonstrated by the good rate of local control.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
