11C-choline PET/CT based helical tomotherapy as treatment approach for bone metastases in recurrent prostate cancer patients

To evaluate the efficacy of 11C-choline PET/CT (CHO-PET/CT) based helical tomotherapy (HTT) as a therapeutic approach for bone metastases in recurrent prostate cancer (PCa) patients. METHODS This retrospective study includes 20 PCa patients (median age: 67; range: 51-80 years) presenting biochemical relapse after primary treatment who underwent CHO-PET/CT based HTT on positive bone metastases from December 2007 to June 2014. The effectiveness of HTT assessed with biochemical response at 3/6/12 months, biochemical relapse free survival (bRFS) and overall survival (OS) at 2 years. Toxicity has been also considered and assessed according to Common Terminology Criteria for Adverse Events (CTCAE). RESULTS All patients presented a relapse at the time of CHO-PET/CT at bone metastases. In addition 15/20 (75%) also at lymph nodes (LNs) level (total lesions= 54). All patients underwent HTT on bone metastases and 19/20 concomitantly on prostatic bed and LNs. The median follow-up from CHO-PET/CT was 2 years (range: 1-7 years). At 3 months, after the beginning of HTT treatment, complete or partial biochemical response occurred in 79% of patients, at 6 months in 82% and at 12 months in 63% of patients. bRFS and OS at 2 years were 50% and 55% of patients, respectively. Patients presented mostly grade 1 or 2 toxicity according to CTCAE. The only grade 3 late toxicity has been observed in one patient. CONCLUSIONS CHO-PET/CT based HTT is a suitable therapeutic approach in patients with recurrent PCa presenting bone metastases with a medium-low toxicity.

Current radiopharmaceuticals. 2017 Sep 19 [Epub ahead of print]

Elena Incerti, Vincenzo Gangemi, Paola Mapelli, Chiara Lucrezia Deantoni, Giampiero Giovacchini, Federico Fallanca, Andrei Fodor, Andrea Ciarmiello, Sergio Baldari, Luigi Gianolli, Nadia Di Muzio, Maria Picchio

Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan. Italy., Unit of Nuclear Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina. Italy., Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan. Italy., Unit of Nuclear Medicine, S. Andrea Hospital, La Spezia. Italy.

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