Department of Radiation Oncology, European Institute of Oncology, Milan, Italy; Department of Health Sciences, University of Milan, Milan, Italy.
Department of Nuclear Medicine, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
Clin Genitourin Cancer. 2014 Jun;12(3):155-9. doi: 10.1016/j.clgc.2013.11.002. Epub 2013 Nov 12.
The purpose of our study was to analyze the role of [(11)C]choline-positron emission tomography/computed tomography (cho-PET/CT) in the management of patients with prostate cancer referred for radiotherapy.
Inclusion criteria for this retrospective study were (1) presence of prostate cancer, (2) referral for first radiotherapy course (for primary or recurrent tumor) between February 2007 and July 2010, and (3) performance of cho-PET/CT. All cho-PET/CT scans were classified according to whether they were positive in the prostate/prostate bed (T), pelvic lymph nodes (N), and distant metastases (M) or negative. Therapeutic strategy based on the cho-PET/CT evaluation was compared with the strategy that would have been proposed had cho-PET/CT imaging not been available, following international and national prostate cancer guidelines.
Eighty-two cho-PET/CT scans performed in 74 patients were analyzed. Cho-PET/CT was positive in 49 studies (60%): T only in 22 (45% of all positive studies); N only in 4 (8%); T in combination with N in 3 (6%); and M in combination with T or N, or both, in 16 (33%). Treatment after positive cho-PET/CT examination included radiotherapy ± androgen deprivation (29 patients), surgery ± radiotherapy (6 patients), androgen deprivation only (8 patients), and other treatment (6 patients). In 22 cases, cho-PET/CT (27%) altered the treatment approach compared with the treatment that would have been adopted in the absence of cho-PET/CT analysis.
Cho-PET/CT is valuable in defining the extent of disease and supporting therapeutic decisions in the management of prostate cancer. The therapeutic strategy turned out to be influenced by cho-PET/CT imaging in about one third of the patients included in this study.
我们研究的目的是分析[(11)C]胆碱正电子发射断层扫描/计算机断层扫描(cho-PET/CT)在前列腺癌患者放疗管理中的作用。
这项回顾性研究的纳入标准为:(1) 存在前列腺癌,(2) 于 2007 年 2 月至 2010 年 7 月期间首次接受放疗(用于原发性或复发性肿瘤),以及 (3) 进行 cho-PET/CT。所有 cho-PET/CT 扫描根据前列腺/前列腺床(T)、盆腔淋巴结(N)和远处转移(M)是否阳性进行分类。根据国际和国家前列腺癌指南,将基于 cho-PET/CT 评估的治疗策略与如果没有 cho-PET/CT 成像则会提出的策略进行比较。
分析了 74 例患者的 82 次 cho-PET/CT 扫描。49 次扫描(60%)呈阳性:T 仅阳性 22 次(所有阳性研究的 45%);N 仅阳性 4 次(8%);T 与 N 联合阳性 3 次(6%);M 与 T 或 N 联合阳性,或两者均阳性 16 次(33%)。阳性 cho-PET/CT 检查后的治疗包括放疗±雄激素剥夺(29 例)、手术+放疗(6 例)、雄激素剥夺治疗(8 例)和其他治疗(6 例)。在 22 例(27%)中,cho-PET/CT(与无 cho-PET/CT 分析相比)改变了治疗方法。
cho-PET/CT 在确定疾病范围和支持前列腺癌治疗决策方面具有重要价值。在本研究纳入的患者中,大约有三分之一的患者的治疗策略受到 cho-PET/CT 影像学的影响。