Several trials have evaluated the impact of PSMA-PET on salvage radiation for prostate cancer. In this randomized phase 2 trial of 124 patients receiving salvage radiation after prostatectomy, PSMA-PET was used to intensify treatment. In the experimental arm, PSMA-avid sites of disease could receive an EQD2 of 66 Gy to nodes and 77 Gy to the prostate fossa while those in the standard arm receive standard fossa dose with elective nodal coverage at physician discretion. Over 80% in both arms received ADT. PSMA-guided dose intensification significantly improved failure free survival and eugonadal failure free survival without an increase in toxicity. | Balliveau, JAMA Oncol 2025
