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أعرض في EDS

Multiparametric MRI as a Predictor of PSA Response in Patients Undergoing Stereotactic Body Radiation Therapy for Prostate Cancer

التفاصيل البيبلوغرافية
العنوان: Multiparametric MRI as a Predictor of PSA Response in Patients Undergoing Stereotactic Body Radiation Therapy for Prostate Cancer
المؤلفون: Kareem Rayn, MD, Israel Deutsch, MD, Brian Jeffers, BS, Albert Lee, MD, Elizaveta Lavrova, BS, Matthew Gallitto, MD, Mark Mayeda, MD, Mark Hwang, MD, James Yu, MD, Catherine Spina, MD, Lawrence Koutcher, MD
المصدر: Advances in Radiation Oncology, Vol 9, Iss 3, Pp 101408- (2024)
بيانات النشر: Elsevier, 2024.
سنة النشر: 2024
المجموعة: LCC:Medical physics. Medical radiology. Nuclear medicine
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
مصطلحات موضوعية: Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
الوصف: Purpose: To maximize the therapeutic ratio, it is important to identify adverse prognostic features in men with prostate cancer, especially among those with intermediate risk disease, which represents a heterogeneous group. These men may benefit from treatment intensification. Prior studies have shown pretreatment mpMRI may predict biochemical failure in patients with intermediate and/or high-risk prostate cancer undergoing conventionally fractionated external beam radiation therapy and/or brachytherapy. This study aims to evaluate pretreatment mpMRI findings as a marker for outcome in patients undergoing stereotactic body radiation therapy (SBRT). Methods and Materials: We identified all patients treated at our institution with linear accelerator based SBRT to 3625 cGy in 5 fractions, with or without androgen deprivation therapy (ADT) from November 2015 to March 2021. All patients underwent pretreatment Magnetic Resonance Imaging (MRI). Posttreatment Prostate Specific Imaging (PSA) measurements were typically obtained 4 months after SBRT, followed by every 3 to 6 months thereafter. A 2 sample t test was used to compare preoperative mpMRI features with clinical outcomes. Results: One hundred twenty-three men were included in the study. Pretreatment MRI variables including median diameter of the largest intraprostatic lesion, median number of prostate lesions, and median maximal PI-RADS score, were each predictive of PSA nadir and time to PSA nadir (P < .0001). When separated by ADT treatment, this association remained for patients who were not treated with ADT (P < .001). In patients who received ADT, the pretreatment MRI variables were each significantly associated with time to PSA nadir (P < .01) but not with PSA nadir (P > 0.30). With a median follow-up time of 15.9 months (IQR: 8.5-23.3), only 3 patients (2.4%) experienced biochemical recurrence as defined by the Phoenix criteria. Conclusions: Our experience shows the significant ability of mpMRI for predicting PSA outcome in prostate cancer patients treated with SBRT with or without ADT. Since PSA nadir has been shown to correlate with biochemical failure, this information may help radiation oncologists better counsel their patients regarding outcome after SBRT and can help inform future studies regarding who may benefit from treatment intensification with, for example, ADT and/or boosts to dominant intraprostatic lesions.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2452-1094
Relation: http://www.sciencedirect.com/science/article/pii/S2452109423002361; https://doaj.org/toc/2452-1094
DOI: 10.1016/j.adro.2023.101408
URL الوصول: https://doaj.org/article/dedbfd90462d48e381d51bbf23ffd348
رقم الأكسشن: edsdoj.bfd90462d48e381d51bbf23ffd348
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:24521094
DOI:10.1016/j.adro.2023.101408