n-n-dimethyl-n-(18f)fluoromethyl-2-hydroxyethylammonium and Prostatic-Neoplasms--Castration-Resistant

The primary objective of this study was to assess clinical outcomes in patients with oligometastatic prostate cancer recurrence after single or repeated salvage radiation treatment.. Forty-nine consecutive prostate cancer patients diagnosed with oligometastatic recurrence on Ch-PET have been prospectively treated. Seven (23%) patients had castrate-resistant disease. Clinical outcomes were assessed using the Kaplan-Meier method. Potential prognostic factors were examined using univariate proportional hazards regression.. The treatments administered to the initial oligorecurrence sites were intensity-modulated radiotherapy (IMRT) ± ADT (26 patients; 53%) and stereotactic ablative radiotherapy (SABR) ± ADT (23 patients; 47%). With a median follow-up of 24 months (range 6-39), 24 patients developed a biochemical failure. Twenty out of the 24 relapsed patients underwent a second Ch-PET/CT. Seven patients presented poly-metastatic relapse and 10 oligometastatic diseases. Six of 10 patients with a second oligorecurrence were treated again with SABR. Overall, 102 lesions were treated. Local control was detected in 45 (91.8%) patients. No relevant (grade ≥ 2) toxicity was reported, and there was no grade 3 toxicity. On univariate analysis, none of the variables were significantly predicted for clinical disease-free survival. At last follow-up visit, 24 patients (40%) were free from biochemical failure and 37 (71%) patients were free from clinical disease. The 2-year OS and PCSS were 91.8% and 95.9% respectively.. Salvage IMRT or SBRT of oligometastatic prostate cancer recurrence is associated with a prolonged cDFS. This may result in a longer time to develop castrate-resistant disease and a longer time without systemic therapies.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Bone Neoplasms; Carcinoma; Choline; Fluorine Radioisotopes; Humans; Kaplan-Meier Estimate; Lymph Nodes; Male; Middle Aged; Neoplasm Recurrence, Local; Positron Emission Tomography Computed Tomography; Proportional Hazards Models; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Radiosurgery; Radiotherapy, Intensity-Modulated; Salvage Therapy

To date, bone metastases remain the main cause of morbidity and mortality in patients with metastatic castration-resistant prostate cancer (mCRPC). Therefore, the combination of accurate early detection of bony disease and effective treatment of these lesions is crucial in the management of mCRPC patients, but clinical trials specifically designed to test novel approaches are currently lacking.. This report describes the case of a 74-year-old male with bone mCRPC and symptomatic and biochemical progression, who underwent radium-223 therapy, following previous treatment failure. 18F-choline positron emission tomography (PET)/computed tomography (CT) was used to assess changes in skeletal tumor activity before and after radium-223. Changes in prostate-specific antigen and alkaline phosphatase were also determined. 18F-choline PET/CT showed that treatment with radium-223 was able to effectively reduce bone metastatic disease, and this was accompanied by an excellent metabolic response.. In clinical practice, metabolic assessment of lesions by 18F-choline PET/CT following radium-223 seems a valid approach to monitor treatment response. Until results from clinical trials become available, reporting of single cases relating to data on the use of this technique remains paramount.

Topics: Adenocarcinoma; Aged; Bone Neoplasms; Choline; Fluorine Radioisotopes; Humans; Male; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms, Castration-Resistant; Radium

High rate of non-target lesions in metastatic castration-resistant prostate cancer usually limits applicability of Response Evaluation Criteria in Solid Tumors (RECIST) criteria, and this has led to a growing interest in using PET/computed tomography (CT). We prospectively investigated the role of (18)F-choline (FCH)-PET/CT in patients receiving enzalutamide after docetaxel.. 30 patients were monitored by means of FCH-PET/CT before and during the treatment. A Cox proportional hazards regression model was used to assess the associations between metabolic parameters and clinical outcomes.. Univariate analysis showed no significant correlation between biochemical and FCH-PET responses. Multivariate analysis showed that only baseline maximum standardized uptake value (SUVmax) significantly correlated with biochemical progression-free survival, radiological progression-free survival and overall survival.. Our findings suggest that FCH-PET/CT may play a role in defining prognosis of patients receiving enzalutamide because baseline SUVmax proved to be an independent prognostic factor.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents; Benzamides; Biomarkers, Tumor; Bone Neoplasms; Choline; Disease-Free Survival; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Nitriles; Phenylthiohydantoin; Positron-Emission Tomography; Proportional Hazards Models; Prostatic Neoplasms, Castration-Resistant; Radiopharmaceuticals; Tissue Distribution; Treatment Outcome