查看更多>>摘要:New research on Oncology-Prostate Ca ncer is the subject of a report. According to news reporting originating from Bo logna, Italy, by NewsRx correspondents, research stated, "Salvage radiation ther apy (sRT) is often the sole curative option in patients with biochemical recurre nce after radical prostatectomy. After sRT, we developed and validated a nomogra m to predict freedom from biochemical failure." Our news editors obtained a quote from the research from the Division of Nuclear Medicine, "This study aims to evaluate prostate-specific membrane antigen-posit ron emission tomography (PSMA-PET)-based sRT efficacy for postprostatectomy pros tate-specific antigen (PSA) persistence or recurrence. Objectives include develo ping a random survival forest (RSF) model for predicting biochemical failure, co mparing it with a Cox model, and assessing predictive accuracy over time. Multin ational cohort data will validate the model's performance, aiming to improve cli nical management of recurrent prostate cancer. This multicenter retrospective st udy collected data from 13 medical facilities across 5 countries: Germany, Cypru s, Australia, Italy, and Switzerland. A total of 1029 patients who underwent sRT following PSMAPET- based assessment for PSA persistence or recurrence were incl uded. Patients were treated between July 2013 and June 2020, with clinical decis ions guided by PSMA-PET results and contemporary standards. The primary end poin t was freedom from biochemical failure, defined as 2 consecutive PSA rises > 0.2 ng/mL after treatment. Data were divided into training (708 patients), testi ng (271 patients), and external validation (50 patients) sets for machine learni ng algorithm development and validation. RSF models were used, with 1000 trees p er model, optimizing predictive performance using the Harrell concordance index and Brier score. Statistical analysis used R Statistical Software (R Foundation for Statistical Computing), and ethical approval was obtained from participating institutions. Baseline characteristics of 1029 patients undergoing sRT PSMA-PET -based assessment were analyzed. The median age at sRT was 70 (IQR 64-74) years. PSMA-PET scans revealed local recurrences in 43.9% (430/979) and nodal recurrences in 27.2% (266/979) of patients. Treatment includ ed dose-escalated sRT to pelvic lymphatics in 35.6% (349/979) of c ases. The external outlier validation set showed distinct features, including hi gher rates of positive lymph nodes (47/50, 94% vs 266/979, 27.2% in the learning cohort) and lower delivered sRT doses ( <66 Gy in 57/979, 5.8% vs 46/50, 92% of patients; P<.001). The RSF model, validated internally and externally, demonstrated robust p redictive performance (Harrell C-index range: 0.54-0.91) across training and val idation datasets, outperforming a previously published nomogram."