{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T19:21:30Z","timestamp":1780428090177,"version":"3.54.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005003","name":"Baskent University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005003","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>This study aimed to investigate the effects of dose escalation through focal boost (FB) to intraprostatic lesions (IPLs) as well as the role of gallium-68 prostate-specific membrane antigen positron-emission tomography (<jats:sup>68<\/jats:sup>Ga-PSMA-PET\/CT) for staging and treatment planning in patients with Gleason score (GS) 10 prostate cancer (PCa) receiving definitive radiotherapy (RT) and androgen deprivation therapy (ADT).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>We retrospectively analyzed data of 92\u00a0patients with GS\u00a010\u00a0PCa who underwent definitive RT and ADT from March 2010 to October 2022. Freedom from biochemical failure (FFBF), prostate cancer-specific survival (PCSS), distant metastasis-free survival (DMFS), and overall survival (OS) rates were calculated using the Kaplan\u2013Meier method. Survival outcomes were compared between patients staged with <jats:sup>68<\/jats:sup>Ga-PSMA-PET\/CT and those staged with conventional imaging modalities as well as between those who received a\u00a0simultaneous integrated boost (SIB) and those who did not.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>At a\u00a0median follow-up time of 73\u00a0months, the 5\u2011year FFBF, PCSS, DMFS, and OS rates were 59.2%, 77.0%, 62.9%, and 67.6%, respectively. Disease progression was observed in 39\u00a0patients (42.4%), with most cases manifesting as distant metastasis (DM). A\u00a0total of 56\u00a0patients (60.9%) were staged using <jats:sup>68<\/jats:sup>Ga-PSMA-PET\/CT, while 43\u00a0patients (46.7%) received FB to IPLs. Patients staged with <jats:sup>68<\/jats:sup>Ga-PSMA-PET\/CT had better FFBF and PCSS compared to those staged with conventional imaging. Patients undergoing an SIB had improved PCSS and DMFS. In the multivariable analysis, an ADT duration of 18\u00a0months or more was associated with improved FFBF, PCSS, DMFS, and OS. Application of an SIB was an additional independent predictor for improved FFBF, while staging with <jats:sup>68<\/jats:sup>Ga-PSMA-PET\/CT was associated with better PCSS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We found that long-term ADT, increasing the radiation dose to primary tumor, and staging with <jats:sup>68<\/jats:sup>Ga-PSMA-PET\/CT improved clinical outcomes. Additional research is needed for validation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00066-025-02376-1","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T13:21:14Z","timestamp":1740748874000},"page":"828-836","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Optimizing treatment for Gleason\u00a010 prostate cancer: radiation dose escalation and 68Ga-PSMA-PET\/CT staging"],"prefix":"10.1007","volume":"201","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-9021","authenticated-orcid":false,"given":"Cem","family":"Onal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6908-3412","authenticated-orcid":false,"given":"Ozan Cem","family":"Guler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-9000","authenticated-orcid":false,"given":"Birhan","family":"Demirhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petek","family":"Erpolat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3855-3391","authenticated-orcid":false,"given":"Aysenur","family":"Elmali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0130-6356","authenticated-orcid":false,"given":"Melek","family":"Yavuz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"issue":"5","key":"2376_CR1","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1016\/j.eururo.2016.11.031","volume":"71","author":"J He","year":"2017","unstructured":"He\u00a0J, Albertsen\u00a0PC, Moore\u00a0D et\u00a0al (2017) Validation of a\u00a0contemporary five-tiered gleason grade grouping using population-based data. 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