PSMA PET/CT improves results for men with repetitive prostate cancer

A new study from Denmark shows for the first time that men with biochemically repetitive prostate cancer undergoing PSMA PET/CT prior to rescue radiotherapy have improved survival rates compared to those who do not.

Using data collected at national level for a period of eight years, researchers have confirmed that PSMA PET/CT is a valuable tool for detecting patients who are likely to benefit from rescue radiotherapy. This survey was published in the August issue of The Nuclear Medicine Magazine.

Biochemical recurrence after radical prostatectomy occurs in up to 40 % of patients with prostate cancer and is recommended to rescue radiotherapy as the main therapeutic choice. With rescue radiotherapy, doctors are based on imaging to accurately detect recurrences for targeted treatment. While this imaging was previously performed with bone spark, CT or MRI, the excellent diagnostic capacity of the PSMA PET/CT makes the current method of selection.

It is widely accepted that PSMA PET/CT is more accurate than other imaging methods for the return of prostate cancer and that it often changes patient therapy strategies, said Anna W. Mogensen, MSc, a doctoral student at the Aalborg Nuclear Medicine Department at Aalborg. However, it remained unclear if changes with PSMA PET/CT are led to the treatment strategy have led to improved survival.

Continued, the PSMA PET/CT was introduced to Denmark in 2015. However, all areas did not adopt the imaging method at the same time. Using the Nationwide Health Registry of Denmark, my colleagues and I wrote a large and comprehensive set of data to compare the overall survival between patients who underwent PSMA PET/CT before rescue radiotherapy and those who did not.

The study used data obtained from the usual clinical practice of all patients who received rescue radiotherapy in Denmark from 2015 to 2023. In total, 844 patients were categorized in accordance with whether they were pre -processed PSMA PET/CT (308). The researchers compared the overall survival, as well as the survival without biochemical recurrence, for up to five years after the completion of the rescue radiotherapy.

The analysis revealed greater overall survival for patients who underwent PT/CT prior to rescue radiotherapy than for patients who did not. The survival rates of one, two and five years of survival for patients with PSMA PET/CT were 100, 99.5 and 98.1 % respectively, compared to 99, 97.8 and 93.8 % respectively for patients with PSMA PET/CT.

The three -year survival rate without biochemical repetition was in accordance with total survival: 74.9 % for patients with PSMA PET/CT and 69.4 % for patients with PSMA PET/CT.

Our findings show that PSMA PET/CT scans can help clinicians to choose patients who are more likely to experience success with rescue radiotherapy. This means that fewer patients may receive unnecessary treatment, and more will be equipped with proper care, Mogensen said. These findings support broader use of nuclear medicine techniques to guide treatment and suggest that the integration of visualization early on treatment decisions could become a new standard in cancer care.