Planning of External Beam Radiotherapy for Prostate Cancer Guided by PET/CT

Author(s): Finn Edler von Eyben, Kalevi Kairemo, Timo Kiljunen, Timo Joensuu.

Journal Name: Current Radiopharmaceuticals

Volume 8 , Issue 1 , 2015

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Abstract:

In this paper, we give an overview of articles on non-choline tracers for PET/CT for patients with prostate cancer and planning of radiotherapy guided by PET/CT. Nineteen articles described 11C-Acetate PET/CT. Of 629 patients 483 (77%, 95% CI 74% - 80%) had positive 11C-Acetate PET/CT scans. Five articles described 18F-FACBC PET/CT. Of 174 patients, 127 (73%, 95% CI 68% - 78%) had positive scans. Both tracers detected local lesions, lesions in regional lymph nodes, and distant organs. Ten articles described 18F-NaF PET/CT and found that 1289 of 3918 patients (33%) had positive reactive lesions in bones. PET/CT scan can guide external beam radiotherapy (EBRT) planning for patients with loco-regional prostate cancer. In six studies with 178 patients with localized prostate cancer, PET/CT pointed out dominant intraprostatic lesions (DIL). Oncologists gave EBRT to the whole prostate and a simultaneously integrated boost to the DIL. Four studies with 254 patients described planning of EBRT for patients with PETpositive lymph nodes. After the EBRT, 15 of 29 node-positive patients remained in remission for median 28 months (range 14 to 50 months). Most articles describe 11C- and 18F-Choline PET/CT. However, 11C-Acetate and 18F-FACBC may also be useful tracers for PET/CT. Planning of radiotherapy guided by MRI or PET/CT is an investigational method for localized prostate cancer. Current clinical controlled trials evaluate whether the method improves overall survival.

Keywords: Androgen deprivation therapy, computed tomography, external bam radiotherapy, positron emission tomography, prostate cancer, radiopharmaceuticals, radiotherapy planning.

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Article Details

VOLUME: 8
ISSUE: 1
Year: 2015
Page: [19 - 31]
Pages: 13
DOI: 10.2174/1874471008666150316222203

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