Influence of 11C-choline PET/CT on radiotherapy planning in prostate cancer

Abstract Aim To evaluate the influence of 11 C-choline PET/CT on radiotherapy planning in prostate cancer patients. Background Precise information on the extension of prostate cancer is crucial for the choice of an appropriate therapeutic strategy. 11 C-choline positron emission tomography ( 11 C-choline PET/CT) has two roles in radiation oncology (RT): (1) patient selection for treatment and (2) target volume selection and delineation. In conjunction with high-accuracy techniques, it might offer an opportunity of dose escalation and better tumour control while sparing healthy tissues. Materials and methods We carried out a retrospective study in order to analyse RT planning modification based on 11 C-choline PET/CT in 16 prostate cancer patients. Patients were treated with hypofractionated step-and-shoot Intensity Modulated Radiotherapy (IMRT), or Volumetric Modulated Arc Therapy (VMAT), and a daily cone-beam CT for Image Guided Radiation Therapy (IGRT). All patients underwent a 11 C-choline-PET/CT scan prior to radiotherapy. Results In 37.5% of cases, a re-delineation and new dose prescription occurred. Data show good preliminary clinical results in terms of biochemical control and toxicity. No gastrointestinal (GI)/genitourinary (GU) grade III toxicities were observed after a median follow-up of 9.5 months. Conclusions In our experience, concerning the treatment of prostate cancer (PCa), 11 C-choline PET/CT may be helpful in radiotherapy planning, either for dose escalation or exclusion of selected sites.