DCFPyL has a half-life of 110 minutes, and its production does not require an on-site cyclotron. Similar to PSMA PET tracer, DCFPyL may be useful to select patients for PSMA therapy, which is recently approved by FDA [88]. Radiography Skeletal Survey Radiographic survey is not routinely used in the evaluation of prostate cancer recurrence. Variant 2: Prostate cancer follow-up. Clinical concern for residual or recurrent disease after nonsurgical local and pelvic treatments. This variant covers the evaluation of BCR in the setting of a broad range of failed treatments targeted locally or to the pelvis, other than RP that is specifically covered in Variant 1. This includes primary radiation therapies, ablation therapies, and secondarily failed salvage therapies, such as failed salvage RT done after RP. RT is commonly performed in the setting of BCR after RP. Guidelines were published in 2013 jointly by ASTRO/AUA and largely endorsed by the American Society of Clinical Oncology [23]. There are 2 distinct clinical scenarios: adjuvant therapy and salvage therapy. It is known that patients with adverse risk factors found at the time of RP (high Gleason scores and/or adverse pathology, extracapsular extension or T4 invasion, seminal vesicle invasion, or positive margins) are at increased risk for BCR [99-105]. In this subgroup, there is consideration for adjuvant RT intended to reduce the high Post-Treatment Follow-up of Prostate Cancer likelihood of recurrence and progression of disease, which is commonly performed approximately 4 to 6 months after surgery. There is strong evidence that adjuvant RT in this setting reduces the risk of BCR and clinical progression of cancer, but the evidence is much less clear on the impact on overall survival. BCR is associated with subsequent progression to metastatic disease and death.
Post Treatment Follow up of Prostate Cancer. DCFPyL has a half-life of 110 minutes, and its production does not require an on-site cyclotron. Similar to PSMA PET tracer, DCFPyL may be useful to select patients for PSMA therapy, which is recently approved by FDA [88]. Radiography Skeletal Survey Radiographic survey is not routinely used in the evaluation of prostate cancer recurrence. Variant 2: Prostate cancer follow-up. Clinical concern for residual or recurrent disease after nonsurgical local and pelvic treatments. This variant covers the evaluation of BCR in the setting of a broad range of failed treatments targeted locally or to the pelvis, other than RP that is specifically covered in Variant 1. This includes primary radiation therapies, ablation therapies, and secondarily failed salvage therapies, such as failed salvage RT done after RP. RT is commonly performed in the setting of BCR after RP. Guidelines were published in 2013 jointly by ASTRO/AUA and largely endorsed by the American Society of Clinical Oncology [23]. There are 2 distinct clinical scenarios: adjuvant therapy and salvage therapy. It is known that patients with adverse risk factors found at the time of RP (high Gleason scores and/or adverse pathology, extracapsular extension or T4 invasion, seminal vesicle invasion, or positive margins) are at increased risk for BCR [99-105]. In this subgroup, there is consideration for adjuvant RT intended to reduce the high Post-Treatment Follow-up of Prostate Cancer likelihood of recurrence and progression of disease, which is commonly performed approximately 4 to 6 months after surgery. There is strong evidence that adjuvant RT in this setting reduces the risk of BCR and clinical progression of cancer, but the evidence is much less clear on the impact on overall survival. BCR is associated with subsequent progression to metastatic disease and death.