Evidence map›Paper›PMID 42005712›Full record

ArticleClinical and translational radiation oncology2026

Oncological outcomes following PSMA PET/CT-guided salvage whole-pelvis radiotherapy for recurrent prostate cancer.

L G Zuur, A Jansen, S H van der Graaf, K C C de Bie, E E Schaake, F J Pos, A N Vis, H G van der Poel, W V Vogel, P J van Leeuwen

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Article in Clinical and translational radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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10 authors.

L G ZuurDepartment of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
A JansenDepartment of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
S H van der GraafDepartment of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
K C C de BieProstate Cancer Network Netherlands, Amsterdam, the Netherlands.
E E SchaakeDepartment of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
F J PosDepartment of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
A N VisProstate Cancer Network Netherlands, Amsterdam, the Netherlands.
H G van der PoelDepartment of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
W V VogelDepartment of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
P J van LeeuwenDepartment of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and purpose: In patients with biochemical recurrence (BCR) after radical prostatectomy (RP), prostate-specific membrane antigen (PSMA) PET/CT can detect early pelvic lymph node metastases, yet optimal management of these recurrences remains unclear. This study evaluates oncological outcomes of patients with BCR after RP and (confirmed or suspected) pelvic lymph node metastases who were treated with PSMA PET/CT-guided salvage whole pelvis radiotherapy (sWPRT) and Androgen Deprivation Therapy (ADT). Materials and methods: This single-centre retrospective analysis included 149 patients undergoing sWPRT and 2-3 years ADT after PSMA PET/CT for BCR following RP ± ePLND (2018-2022). sWPRT was offered to BCR patients with ≤ 6 pelvic PSMA-positive nodes, or to PSMA-negative patients with prior pN1 disease. Outcomes included biochemical progression-free survival (bPFS), metastasis-free survival (MFS), treatment-free survival (TFS), overall survival (OS), and cancer-specific survival (CSS). Multivariate Cox regression identified predictors of biochemical progression. Recurrence locations on PSMA PET/CT were recorded and correlated with radiotherapy fields. Results: After a median 54-month follow-up, 5-year bPFS, MFS, TFS, OS and CSS were; 69.3%, 79.0%, 78.5%, 91.7% and 97.5%. Outcomes did not differ between PSMA-negative and PSMA-positive subgroups. Biochemical progression occurred in 37 patients (25%), with rare in-field recurrences (1/37) and predominantly out-field nodal recurrences (29/37). Higher pre-sWPRT PSA (HR = 3.88, p = 0.021) and longer ADT duration (HR = 0.92, p < 0.001) independently predicted biochemical progression. Conclusion: PSMA PET/CT-guided sWPRT with ADT provides good in-field tumour control and good 5-year oncological outcomes in patients with BCR following RP. PSA prior to sWPRT and ADT duration were significant predictors for bPFS.

Indexed as

Lymph nodesPelvicProstate cancerPSMA-PET/CT-guidedRadiotherapySalvage

Identifiers

PMID42005712
PMCPMC13091081

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