AUTHOR=Champion Ambroise , Zwhalen Daniel Rudolf , Oehler Christoph , Taussky Daniel , Kroeze Stephanie G. C. , Burger Irene A. , Benzaquen David 

TITLE=Can PSMA PET/CT help in dose-tailoring in post-prostatectomy radiotherapy?

JOURNAL=Frontiers in Oncology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1268309

DOI=10.3389/fonc.2023.1268309

ISSN=2234-943X

ABSTRACT=<p>There are few randomized trials to evaluate the use of PSMA-PET in the planning of post-prostatectomy radiotherapy. There are two unresolved questions 1) should we increase the dose to lesions visible on PSMA-PET 2) can we reduce dose in the case of a negative PSMA-PET. In this review, we summarize and discuss the available evidence in the literature. We found that in general, there seems to be an advantage for dose-increase, but ta large recent study from the pre-PSMA era didn’t show an advantage for dose escalation. Retrospective studies have shown that conventional doses to PSMA-PET-positive lesions seem sufficient. On the other hand, in the case of a negative PSMA-PET, there is no evidence that dose-reduction is possible. In the future, the combination of PSMA-PET with genomic classifiers could help in better identify patients who might benefit from either dose- de-or -increase. We further need to identify intraindividual references to help identify lesions with higher aggressiveness.</p>