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Salvage Radiotherapy Confers an Overall Survival Advantage in Biochemical Recurrence of Prostate Cancer : Evidence from the International PROMISE Registry

Guberina, Nika ; Karpinski, Madeleine J. ; Guberina, Maja ; Hoberück, Sebastian ; Miederer, Matthias ; Hölscher, Tobias ; Rauscher, Isabel ; Eiber, Matthias ; Nguyen, Andrew and Theus, Lela , et al. (2026) In Journal of Nuclear Medicine p.1-7
Abstract

The impact of salvage radiotherapy (SRT) on overall survival (OS) in patients experiencing biochemical recurrence (BCR) of prostate cancer remains an area of active investigation. The international multicenter PROMISE registry provides a valuable dataset to explore the association between SRT and long-term clinical outcomes in this patient population (NCT06320223). Methods: Comprehensive restaging at the time of BCR was performed by integrating both serologic markers and advanced molecular imaging (PET/CT or PET/MRI), offering an accurate assessment of molecular imaging (mi) TNM stage. Results: In total, 1410 patients experiencing BCR with prior prostatectomy were included. The median follow-up was 5.2 y (interquartile range, 3.8–6.9... (More)

The impact of salvage radiotherapy (SRT) on overall survival (OS) in patients experiencing biochemical recurrence (BCR) of prostate cancer remains an area of active investigation. The international multicenter PROMISE registry provides a valuable dataset to explore the association between SRT and long-term clinical outcomes in this patient population (NCT06320223). Methods: Comprehensive restaging at the time of BCR was performed by integrating both serologic markers and advanced molecular imaging (PET/CT or PET/MRI), offering an accurate assessment of molecular imaging (mi) TNM stage. Results: In total, 1410 patients experiencing BCR with prior prostatectomy were included. The median follow-up was 5.2 y (interquartile range, 3.8–6.9 y). SRT was administered after PET to 381 of 680 patients (56.0%) with PET-negative disease (miT0N0M0) and to 478 of 730 patients (65.0%) with PET-locoregional disease (miT/N1 M0). SRT was associated with longer OS in the entire cohort (hazard ratio, 0.66; 95% CI, 0.47–0.93; P 5 0.019) with 5- and 7-y survival rates of 95.2% (95% CI, 93.6%–96.8%) and 90.8% (95% CI, 88.1%–93.6%), respectively. Without SRT, 5- and 7-y survival rates were 92.1% (95% CI, 89.6%–94.7%) and 83.8% (95% CI, 79.8%–88.1%), respectively. Subgroup analysis found significant benefit for patients with miT0N0M0 disease (hazard ratio, 0.42; 95% CI, 0.22–0.78; P 5 0.0061), particularly those with a prostate-specific antigen level of 0.5 ng/mL or lower (P 5 0.03, log-rank test). Conclusion: SRT improves OS for patients with BCR, especially those with a negative prostate-specific membrane antigen–targeted PET.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
biochemical recurrence, molecular imaging, overall survival, prostate cancer, salvage radiotherapy
in
Journal of Nuclear Medicine
pages
7 pages
publisher
Society of Nuclear Medicine Inc.
external identifiers
  • pmid:42167806
  • scopus:105046445252
ISSN
0161-5505
DOI
10.2967/jnumed.125.271770
language
English
LU publication?
yes
id
020b4ee6-f28c-4f86-887c-d4dfb2b7383f
date added to LUP
2026-09-03 15:40:05
date last changed
2026-10-02 06:56:14
@article{020b4ee6-f28c-4f86-887c-d4dfb2b7383f,
  abstract     = {{<p>The impact of salvage radiotherapy (SRT) on overall survival (OS) in patients experiencing biochemical recurrence (BCR) of prostate cancer remains an area of active investigation. The international multicenter PROMISE registry provides a valuable dataset to explore the association between SRT and long-term clinical outcomes in this patient population (NCT06320223). Methods: Comprehensive restaging at the time of BCR was performed by integrating both serologic markers and advanced molecular imaging (PET/CT or PET/MRI), offering an accurate assessment of molecular imaging (mi) TNM stage. Results: In total, 1410 patients experiencing BCR with prior prostatectomy were included. The median follow-up was 5.2 y (interquartile range, 3.8–6.9 y). SRT was administered after PET to 381 of 680 patients (56.0%) with PET-negative disease (miT0N0M0) and to 478 of 730 patients (65.0%) with PET-locoregional disease (miT/N1 M0). SRT was associated with longer OS in the entire cohort (hazard ratio, 0.66; 95% CI, 0.47–0.93; P 5 0.019) with 5- and 7-y survival rates of 95.2% (95% CI, 93.6%–96.8%) and 90.8% (95% CI, 88.1%–93.6%), respectively. Without SRT, 5- and 7-y survival rates were 92.1% (95% CI, 89.6%–94.7%) and 83.8% (95% CI, 79.8%–88.1%), respectively. Subgroup analysis found significant benefit for patients with miT0N0M0 disease (hazard ratio, 0.42; 95% CI, 0.22–0.78; P 5 0.0061), particularly those with a prostate-specific antigen level of 0.5 ng/mL or lower (P 5 0.03, log-rank test). Conclusion: SRT improves OS for patients with BCR, especially those with a negative prostate-specific membrane antigen–targeted PET.</p>}},
  author       = {{Guberina, Nika and Karpinski, Madeleine J. and Guberina, Maja and Hoberück, Sebastian and Miederer, Matthias and Hölscher, Tobias and Rauscher, Isabel and Eiber, Matthias and Nguyen, Andrew and Theus, Lela and Bauckneht, Matteo and Scholtissek, Helen and Rahbar, Kambiz and Miksch, Jonathan and Pizzuto, Daniele Antonio and Goffin, Karolien and Civan, Caner and Reinwand, Shima F. and Stang, Andreas and Kleesiek, Jens and Merkel-Jens, Anja and Umutlu, Lale and Santangelo, Alfonso and Soeterik, Timo F.W. and Beintner-Skawran, Stephan and Vondrak, Andrej and Bjartell, Anders and Evangelista, Laura and Rasul, Sazan and Miszczyk, Marcin and Holzgreve, Adrien and Sheikh, Gabriel T. and Giorgio, Andrea Di and Farolfi, Andrea and Herrmann, Ken and Hadaschik, Boris and Fendler, Wolfgang P. and Stuschke, Martin}},
  issn         = {{0161-5505}},
  keywords     = {{biochemical recurrence; molecular imaging; overall survival; prostate cancer; salvage radiotherapy}},
  language     = {{eng}},
  pages        = {{1--7}},
  publisher    = {{Society of Nuclear Medicine Inc.}},
  series       = {{Journal of Nuclear Medicine}},
  title        = {{Salvage Radiotherapy Confers an Overall Survival Advantage in Biochemical Recurrence of Prostate Cancer : Evidence from the International PROMISE Registry}},
  url          = {{http://dx.doi.org/10.2967/jnumed.125.271770}},
  doi          = {{10.2967/jnumed.125.271770}},
  year         = {{2026}},
}