我们旨在评估使用18 F-氟丝氨酸PET/CT成像对前列腺癌（PCa）复发后挽救性放疗（SRT）的无失败生存（FFS）的影响。在2/3期临床试验中，招募了79位患者进行18 F-氟丝氨酸PET/CT，在SRT之前对PCa进行检查。四名有肿瘤发生在盆腔以外的患者被排除在外。所有患者将定期随访，追踪时间为48个月。治疗失败定义为SRT后血清前列腺特异性抗原水平在残余值以上≥0.2 ng/mL的情况下，需要确认附加测量，需要进行全身治疗或临床进展。计算失败的无失败生存并将其与根据18 F-氟丝氨酸PET/CT成像结果分组的患者进行比较。 80％（60/75）的患者18 F-氟丝氨酸PET/CT检查结果为阳性，其中56.7％（34/60）仅有前列腺床摄取，而43.3％（26/60）是盆腔结节±床摄取。 在SRT后，36％（27/75）的患者发现疾病失败。在具有阳性和阴性扫描的患者之间，无失败生存有显着差异（P <0.001），其中阳性扫描的患者在36个月时的无失败生存率为62.3％，而阴性扫描的患者为92.9％，在48个月时阳性扫描的患者的无失败生存率为59.4％，而阴性扫描的患者为92.9％（P <0.001）。同样，在具有盆腔结节±床和仅存在前列腺病变的患者之间，在36个月时无失败生存率也有显着差异（49.8％与70.7％; P = 0.003），在48个月时差异仍显着（49.8％与65.6％; P = 0.040）。在经历了根治性前列腺切除术后出现PCa复发的男性中，即使通过优化治疗决策和治疗计划进行行动，术前18 F-氟丝氨酸PET/CT成像的发现也能预测根治性前列腺切除术后SRT治疗后的FFS。 负性的18 F-氟丝氨酸PET/CT成像最能预测低失败风险，而盆腔结节复发的存在预示着SRT失败的高风险。 版权所有 © 2023 Wolters Kluwer健康公司，版权所有。

We aimed to evaluate the impact of 18 F-fluciclovine PET/CT imaging on failure-free survival (FFS) post-salvage radiotherapy (SRT) for prostate cancer (PCa) recurrence.Seventy-nine patients were recruited in a phase 2/3 clinical trial to undergo 18 F-fluciclovine PET/CT before SRT for PCa. Four patients with extrapelvic disease were excluded. All patients were followed up at regular intervals up to 48 months. Treatment failure was defined as a serum prostate-specific antigen level of ≥0.2 ng/mL above the nadir after SRT, confirmed with an additional measurement, requiring systemic treatment or clinical progression. Failure-free survival was computed and compared between patients grouped according to 18 F-fluciclovine PET/CT imaging findings.Eighty percent (60/75) of patients had a positive finding on 18 F-fluciclovine PET/CT, of which 56.7% (34/60) had prostate bed-only uptake, whereas 43.3% (26/60) had pelvic nodal ± bed uptake. Following SRT, disease failure was detected in 36% (27/75) of patients. There was a significant difference in FFS between patients who had a positive versus negative scan (62.3% vs 92.9% [ P < 0.001] at 36 months and 59.4% vs 92.9% [ P < 0.001] at 48 months). Similarly, there was a significant difference in FFS between patients with uptake in pelvic nodes ± bed versus prostate bed only at 36 months (49.8% vs 70.7%; P = 0.003) and at 48 months (49.8% vs 65.6%; P = 0.040). Failure-free survival was also significantly higher in patients with either negative PET/CT or prostate bed-only disease versus those with pelvic nodal ± prostate bed disease at 36 (78% vs 49.8%, P < 0.001) and 48 months (74.4% vs 49.8%, P < 0.001).Findings on pre-SRT 18 F-fluciclovine PET/CT imaging, even when acted upon to optimize the treatment decisions and treatment planning, are predictive of post-SRT FFS in men who experience PCa recurrence after radical prostatectomy. A negative 18 F-fluciclovine PET/CT is most predictive of a lower risk of failure, whereas the presence of pelvic nodal recurrence portends a higher risk of SRT failure.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.