PMID- 31673659
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220411
IS  - 2452-1094 (Print)
IS  - 2452-1094 (Electronic)
IS  - 2452-1094 (Linking)
VI  - 4
IP  - 4
DP  - 2019 Oct-Dec
TI  - (11)C-Choline PET Guided Salvage Radiation Therapy for Isolated Pelvic and 
      Paraortic Nodal Recurrence of Prostate Cancer After Radical Prostatectomy: 
      Rationale and Early Genitourinary or Gastrointestinal Toxicities.
PG  - 659-667
LID - 10.1016/j.adro.2019.06.006 [doi]
AB  - PURPOSE: To assess gastrointestinal (GI) and genitourinary (GU) adverse events 
      (AEs) of (11)C-choline-positron emission tomography (CholPET) guided lymph node 
      (LN) radiation therapy (RT) in patients who experience biochemical failure after 
      radical prostatectomy. METHODS AND MATERIALS: From 2013 to 2016, 107 patients 
      experienced biochemical failure of prostate cancer, had CholPET-detected pelvic 
      and/or paraortic LN recurrence, and were referred for RT. Patients received 
      androgen suppression and CholPET guided LN RT (median dose, 45 Gy) with a 
      simultaneous integrated boost to CholPET-avid sites (median dose, 56.25 Gy), all 
      in 25 fractions. RT-naive patients had the prostatic fossa included in the 
      initial treatment volumes followed by a sequential boost (median dose, 68 Gy). GI 
      and GU AEs were reported per Common Terminology Criteria for Adverse Events 
      (version 4.0) with data gathered retrospectively. Differences in maximum GI and 
      GU AEs at baseline, immediately post-RT, and at early (median, 4 months) and late 
      (median, 14 months) follow-up were assessed. RESULTS: Median follow-up was 
      16 months (interquartile range [IQR], 11-25). Median prostate-specific antigen at 
      time of positive CholPET was 2.3 ng/mL (IQR, 1.3-4.8), with a median of 2 (IQR, 
      1-4) choline-avid LNs per patient. Most recurrences were within the pelvis (53%) 
      or pelvis + paraortic (40%). Baseline rates of grade 1 to 2 GI AEs were 8.4% 
      compared with 51.9% (4.7% grade 2) of patients post-RT (P < .01). These 
      differences resolved by 4-month (12.2%, P = .65) and 14-month AE assessments 
      (9.1%, P = .87). There was no significant change in grade 1 to 2 GU AEs post-RT 
      (64.1%) relative to baseline (56.0%, P = .21), although differences did arise at 
      4-month (72.2%, P = .01) and 14-month (74.3%, P = .01) AE assessments. 
      CONCLUSIONS: Salvage CholPET guided nodal RT has acceptably low rates of acute GI 
      and GU AEs and no significant detriment in 14-month GI AEs. These data are of 
      value in counseling patients and designing prospective trials evaluating the 
      oncologic efficacy of this treatment strategy.
CI  - (c) 2019 The Authors.
FAU - Jethwa, Krishan R
AU  - Jethwa KR
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Hellekson, Christopher D
AU  - Hellekson CD
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Evans, Jaden D
AU  - Evans JD
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Harmsen, William S
AU  - Harmsen WS
AD  - Biomedical Statistics and Informatics, Rochester, Minnesota.
FAU - Wilhite, Tyler J
AU  - Wilhite TJ
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Whitaker, Thomas J
AU  - Whitaker TJ
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Park, Sean S
AU  - Park SS
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Choo, C Richard
AU  - Choo CR
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Stish, Bradley J
AU  - Stish BJ
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Olivier, Kenneth R
AU  - Olivier KR
AD  - Department of Radiation Oncology, Rochester, Minnesota.
FAU - Haloi, Rimki
AU  - Haloi R
AD  - Department of Urology, Mayo Clinic, Rochester, Minnesota.
FAU - Lowe, Val J
AU  - Lowe VJ
AD  - Department of Radiology, Rochester, Minnesota.
FAU - Welch, Brian T
AU  - Welch BT
AD  - Department of Radiology, Rochester, Minnesota.
FAU - Quevedo, J Fernando
AU  - Quevedo JF
AD  - Department of Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota.
FAU - Mynderse, Lance A
AU  - Mynderse LA
AD  - Department of Urology, Mayo Clinic, Rochester, Minnesota.
FAU - Karnes, R Jeffrey
AU  - Karnes RJ
AD  - Department of Urology, Mayo Clinic, Rochester, Minnesota.
FAU - Kwon, Eugene D
AU  - Kwon ED
AD  - Department of Urology, Mayo Clinic, Rochester, Minnesota.
FAU - Davis, Brian J
AU  - Davis BJ
AD  - Department of Radiation Oncology, Rochester, Minnesota.
LA  - eng
GR  - R01 CA200551/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20190704
PL  - United States
TA  - Adv Radiat Oncol
JT  - Advances in radiation oncology
JID - 101677247
PMC - PMC6817538
EDAT- 2019/11/02 06:00
MHDA- 2019/11/02 06:01
PMCR- 2019/07/04
CRDT- 2019/11/02 06:00
PHST- 2019/02/04 00:00 [received]
PHST- 2019/06/03 00:00 [revised]
PHST- 2019/06/21 00:00 [accepted]
PHST- 2019/11/02 06:00 [entrez]
PHST- 2019/11/02 06:00 [pubmed]
PHST- 2019/11/02 06:01 [medline]
PHST- 2019/07/04 00:00 [pmc-release]
AID - S2452-1094(19)30084-3 [pii]
AID - 10.1016/j.adro.2019.06.006 [doi]
PST - epublish
SO  - Adv Radiat Oncol. 2019 Jul 4;4(4):659-667. doi: 10.1016/j.adro.2019.06.006. 
      eCollection 2019 Oct-Dec.