CT, MR and nuclear medicine bone scans are conventionally used to guide and monitor targeted treatment for recurrent prostate cancer, but researchers at the Winship Cancer Institute of Emory University may have found a better alternative.

Preliminary results in a three-year study that found fluorine-18-fluciclovine PET/CT can improve radiotherapy targeting were published in the March issue of The Journal of Nuclear Medicine.

“F-18-fluciclovine PET/CT will have in an increasing role for treatment planning in radiotherapy, and study is ongoing to further define its utility in guiding and planning radiotherapy in the post-surgery recurrent prostate cancer setting,” Dr. Ashesh Jani, professor of radiation oncology at the institute and Dr. David M. Schuster, associate professor of radiology and imaging services, told HCB News via e-mail.
Jani, Schuster and the rest of the team had 96 patients undergo initial treatment planning based on results from standard CT or MR abdominopelvic imaging. To better define the tumor-target area and modify treatment planning, 45 of the patients underwent abdominopelvic F-18-fluciclovine PET/CT exams.

They found that including F-18-fluciclovine PET/CT information in the treatment planning process leads to notable differences in the target areas that receive radiotherapy. In addition, they didn’t observe any increase in toxicity.

A higher amount of radiation was delivered to the penile bulb, but there wasn’t any major difference in bladder or rectal radiation dose or in acute genitourinary or gastrointestinal toxicity.

Beside skin cancer, prostate cancer is the most common cancer among men in the U.S., according to the American Cancer Society. It’s estimated that in 2017 there will be about 161,360 new cases of prostate cancer and about 26,730 deaths.

The research team hypothesized that there’s an increase in disease-free survival among patients in the F-18-fluciclovine-modified treatment group compared to those in the standard treatment group.

Jani noted that this study can have implications beyond prostate cancer. The methodology can be applied to other imaging agents and it has the potential to improve cancer control outcomes.

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