{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:17:55Z","timestamp":1790698675503,"version":"4.1.0"},"reference-count":102,"publisher":"Harborside Press, LLC","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Salvage radiotherapy (sRT) is the standard of care for biochemical recurrence of prostate cancer following radical prostatectomy (RP). In this context, prostate-specific membrane antigen (PSMA) PET\/CT offers superior sensitivity and specificity for the detection of recurrent disease. We aimed to evaluate the impact of PSMA PET\/CT\u2013guided management on clinical outcomes following sRT.\n                    <jats:bold>Patients and Methods:<\/jats:bold>\n                    We retrospectively screened 5 prospective PSMA PET\/CT studies conducted between 2016 and 2021. Eligible patients underwent PSMA PET\/CT for restaging at first biochemical recurrence after RP, received sRT, and had \u226524 months of follow-up. Progression-free survival (PFS), freedom from distant progression, and overall survival (OS) were calculated using the Kaplan-Meier method. Adjusted hazard ratios (aHRs) for PFS were derived using Cox proportional hazards regression, adjusting for age, pre-sRT prostate-specific antigen (PSA) level, use of androgen deprivation therapy (ADT), and receipt of whole-pelvis radiotherapy (WPRT).\n                    <jats:bold>Results:<\/jats:bold>\n                    Of the total cohort, 113 patients met the inclusion criteria. Median follow-up was 59.4 months (IQR, 47.4\u201369.5). Median PSA was 0.4 ng\/mL (IQR, 0.3\u20131.1), and the median time from RP was 19.9 months (IQR, 5.6\u201351.8). On PSMA PET\/CT, 19 (16.8%) patients were staged as TrN0M0, 32 (28.3%) as N1M0, 16 (14.2%) as M1, and 46 (40.7%) as T0N0M0 (no visible disease). ADT was administered to 76 (67.3%) patients, and 63 (55.8%) patients received WPRT. Disease progression occurred in 57 (50.4%) patients. Median PFS was 49.2 months (95% CI, 24.1\u201374.3), and median freedom from distant progression was 76.4 months (95% CI, 62.9\u201389.9). The 5-year OS rate was 97.1% (95% CI, 94.1%\u2013100%). Receipt of WPRT was significantly associated with improved PFS among patients staged as TrN0M0 (aHR, 0.12;\n                    <jats:italic>P<\/jats:italic>\n                    =.035), whereas ADT was significantly associated with improved PFS in patients staged as N1\/M1 (aHR, 0.37;\n                    <jats:italic>P<\/jats:italic>\n                    =.024).\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    In this 5-year follow-up study from an institution that was an early adopter of PSMA PET\/CT, PSMA PET\/CT\u2013guided sRT was associated with favorable oncologic outcomes. Exploratory analyses suggest a potential benefit of WPRT following a positive PSMA PET\/CT and of ADT in patients with N1\/M1 disease.\n                  <\/jats:p>","DOI":"10.6004\/jnccn.2025.7102","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T13:46:30Z","timestamp":1770644790000},"page":"11-18","source":"Crossref","is-referenced-by-count":3,"title":["Five-Year Outcomes After Prostate-Specific Membrane Antigen PET\/CT-Guided Salvage Radiotherapy Following Radical Prostatectomy"],"prefix":"10.6004","volume":"24","author":[{"given":"John","family":"Nikitas","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clayton P.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley R.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishnu","family":"Murthy","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"Grogan","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevyn","family":"Clark","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Moore","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makayla","family":"Roberts","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Farolfi","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Reiter","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B.","family":"Rettig","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Department of Medical Oncology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Division of Hematology-Oncology, Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca F.","family":"Valle","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Radiation Oncology Service, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas G.","family":"Nickols","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Radiation Oncology Service, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Czernin","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar U.","family":"Kishan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremie","family":"Calais","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"J Urol","first-page":"517","article-title":"Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer","volume":"169","author":"Han M","year":"2003","unstructured":"Han M, Partin AW, Zahurak M,  Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. 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Clin Transl Radiat Oncol 2023;41:100638."},{"key":"B17","series-title":"Lancet Oncol","first-page":"1286","article-title":"18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial","volume":"20","author":"Calais J","year":"2019","unstructured":"Calais J, Ceci F, Eiber M,  18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial. 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Cancers (Basel) 2023;15:2027."},{"key":"B33","series-title":"Cancers (Basel)","first-page":"3766","article-title":"Salvage nodal radiotherapy as metastasis-directed therapy for oligorecurrent prostate cancer detected by positron emission tomography shows favorable outcome in long-term follow-up","volume":"14","author":"Tamihardja J","year":"2022","unstructured":"Tamihardja J, Zehner L, Hartrampf P,  Salvage nodal radiotherapy as metastasis-directed therapy for oligorecurrent prostate cancer detected by positron emission tomography shows favorable outcome in long-term follow-up. Cancers (Basel) 2022;14:3766."},{"key":"B34","series-title":"Eur Urol Oncol","first-page":"146","article-title":"Prostate-specific membrane antigen positron emission tomography\/computed tomography is associated with improved oncological outcome in men treated with salvage radiation therapy for biochemically recurrent prostate cancer","volume":"5","author":"Meijer D","year":"2022","unstructured":"Meijer D, Eppinga WSC, Mohede RM,  Prostate-specific membrane antigen positron emission tomography\/computed tomography is associated with improved oncological outcome in men treated with salvage radiation therapy for biochemically recurrent prostate cancer. 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