{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T16:40:57Z","timestamp":1769704857611,"version":"3.49.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The advent of prostate-specific membrane antigen - positron emission tomography (PSMA-PET) imaging influences prostate cancer (PCa) salvage radiotherapy (SRT) decision-making, especially in biochemical recurrence (BCR) with low PSA. This study evaluates the impact of PSMA-PET on recurrent post-prostatectomy patients treated with radiotherapy (RT) \u00b1 hormonal therapy (HT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In a prospective, observational study (2016\u20132020), 103 hormone-sensitive post-prostatectomy pN0-pNx PCa patients with proven BCR were analyzed. PSMA-positive patients received tailored treatments based on lesion sites, ranging from prostate bed (P-bed) SRT abort, metastases-directed therapy, to systemic therapy. PSMA-negative patients were mainly treated with SRT. Primary objectives included PSMA-based management changes and biochemical progression-free survival (bPFS) comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PSMA-PET was positive in 28.1% (29\/103) at a median PSA of 0.5 ng\/mL. The most common relapse sites were bones and pelvic lymph nodes. Among positive PSMA-PET patients, the P-bed abort rate was 58.6% (17\/29 patients). Excluding patients with PSMA-positive uptake solely in the P-bed (7 patients), the rate of P-bed abort was 77.3% (17\/22 patients). Management was altered in 75.8% of PSMA-positive and 21.3% overall. Most PSMA-positive lesions were managed with SBRT, either as a standalone treatment or within combined-modality approaches: SBRT was delivered to 50% of nodal recurrences (including both N1 and M1a cases) and to 100% of bone lesions. At 5 years, bPFS was 66.8% in PSMA-negative patients (undergoing SRT+\/-HT) vs. 26.7% in PSMA-positive patients (any treatment).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PSMA-PET led to management changes in nearly one-third of post-prostatectomy recurrent PCa, notably affecting RT strategies and systemic therapy. Emerging evidence suggests that treatment intensification based on PSMA-PET findings may improve patient outcomes compared to de-intensified approaches. The impact on outcomes awaits validation from ongoing prospective randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1764588","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T05:22:52Z","timestamp":1769664172000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["PSMA-guided management of recurrent post-prostatectomy patients: a sub-analysis of a prospective single-center study"],"prefix":"10.3389","volume":"16","author":[{"given":"Giuseppe Carlo","family":"Iorio","sequence":"first","affiliation":[{"name":"Department of Oncology, School of Medicine, University of Turin","place":["Torino, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiano","family":"Grossi","sequence":"additional","affiliation":[{"name":"Department of Oncology, School of Medicine, University of Turin","place":["Torino, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Chiofalo","sequence":"additional","affiliation":[{"name":"Department of Oncology, School of Medicine, University of Turin","place":["Torino, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Richetto","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, A.O.U. Citt\u00e0 della Salute e della Scienza di Torino","place":["Torino, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Rovera","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, AOU Citt\u00e0 della Salute e della Scienza di Torino, University of Turin","place":["Turin, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Bongiovanni","sequence":"additional","affiliation":[{"name":"Department of Oncology, School of Medicine, University of Turin","place":["Torino, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramona","family":"Parise","sequence":"additional","affiliation":[{"name":"Department of Oncology, School of Medicine, University of Turin","place":["Torino, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Clot","sequence":"additional","affiliation":[{"name":"Department of Oncology, School of Medicine, University of Turin","place":["Torino, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Oderda","sequence":"additional","affiliation":[{"name":"Urology Clinic, Department of Surgical Sciences, City of Health and Sciences at Molinette University Hospital, University of Turin","place":["Turin, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, AOU Citt\u00e0 della Salute e della Scienza di Torino, University of Turin","place":["Turin, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica Maria","family":"Cuffini","sequence":"additional","affiliation":[{"name":"Department of Oncology, School of Medicine, University of Turin","place":["Torino, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Levis","sequence":"additional","affiliation":[{"name":"Department of 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