（18）F - FDG - PET/CT和（18）F - NaF - PET/CT在去势抵抗性前列腺癌男性患者中的应用
(18)F-FDG-PET/CT and (18)F-NaF-PET/CT in men with castrate-resistant prostate cancer.
作者信息
Zukotynski Katherine A, Kim Chun K, Gerbaudo Victor H, Hainer Jon, Taplin Mary-Ellen, Kantoff Philip, den Abbeele Annick D Van, Seltzer Steven, Sweeney Christopher J
机构信息
Brigham and Women's Hospital, Harvard Medical School Boston, MA, USA ; Dana-Farber Cancer Institute, Harvard Medical School Boston, MA, USA ; Sunnybrook Health Sciences Centre, University of Toronto ON, Canada.
Brigham and Women's Hospital, Harvard Medical School Boston, MA, USA ; Dana-Farber Cancer Institute, Harvard Medical School Boston, MA, USA.
出版信息
Am J Nucl Med Mol Imaging. 2014 Dec 15;5(1):72-82. eCollection 2015.
To evaluate (18)F-labeled-fluorodeoxyglucose ((18)F-FDG-) and (18)F-labeled-sodium fluoride ((18)F-NaF-) positron emission tomography/computed tomography (PET/CT) as biomarkers in metastatic castrate-resistant prostate cancer (mCRPC). Nine men (53-75 years) in a phase 1 trial of abiraterone and cabozantinib had (18)F-FDG-PET/CT, (18)F-NaF-PET/CT and standard imaging ((99m)Tc-labeled-methylene-diphosphonate ((99m)Tc-MDP) bone scan and abdominal/pelvic CT) at baseline and after 8 weeks of therapy. Baseline disease was classified as widespread (18)F-FDG-avid, oligometastatic (18)F-FDG-avid (1 site), or non-(18)F-FDG-avid. Metabolic response was classified using European Organisation for Research and Treatment of Cancer (EORTC) criteria. Treatment response using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, Prostate Cancer Working Group 2 (PCWG2) guidelines and days on trial (DOT) were recorded. All men were followed for 1 year or until progression. Four men had (18)F-FDG-avid disease: two with widespread (DOT 53 and 76) and two with oligometastatic disease (DOT 231 and still on trial after 742+ days). Five men had non-(18)F-FDG-avid disease; three remained stable or improved (2 still on trial while one discontinued for non-oncologic reasons; DOT 225-563+), and 2 progressed (DOT 285 and 532). Despite the small sample size, Kaplan-Meier analysis showed a significant difference in progression free survival (PFS) between men with widespread (18)F-FDG-avid, oligometastatic (18)F-FDG-avid and non-(18)F-FDG-avid disease (p < 0.01). All men had (18)F-NaF-avid disease. Neither (18)F-NaF-avid disease extent nor intensity was predictive of treatment response. (18)F-FDG-PET/CT may be superior to (18)F-NaF-PET/CT and standard imaging in men with mCRPC on abiraterone and cabozantinib. (18)F-FDG-PET/CT may have potential to stratify men into 3 groups (widespread vs. oligometastatic (18)F-FDG-avid vs. non-(18)F-FDG-avid mCRPC) to tailor therapy. Further evaluation is warranted.
评估¹⁸F标记的氟脱氧葡萄糖（¹⁸F-FDG）和¹⁸F标记的氟化钠（¹⁸F-NaF）正电子发射断层扫描/计算机断层扫描（PET/CT）作为转移性去势抵抗性前列腺癌（mCRPC）生物标志物的价值。9名年龄在53 - 75岁的男性参与了阿比特龙和卡博替尼的1期试验，在基线期和治疗8周后接受了¹⁸F-FDG-PET/CT、¹⁸F-NaF-PET/CT以及标准成像（⁹⁹ᵐTc标记的亚甲基二膦酸盐（⁹⁹ᵐTc-MDP）骨扫描和腹部/盆腔CT）。基线疾病被分类为广泛¹⁸F-FDG摄取、寡转移¹⁸F-FDG摄取（1个部位）或非¹⁸F-FDG摄取。代谢反应根据欧洲癌症研究与治疗组织（EORTC）标准进行分类。记录使用实体瘤疗效评价标准（RECIST）1.1、前列腺癌工作组2（PCWG2）指南和试验天数（DOT）评估的治疗反应。所有男性均随访1年或直至疾病进展。4名男性患有¹⁸F-FDG摄取性疾病：2名广泛摄取（DOT分别为53和76），2名寡转移摄取（DOT分别为231，742 +天后仍在试验中）。5名男性患有非¹⁸F-FDG摄取性疾病；3名病情稳定或改善（2名仍在试验中，1名因非肿瘤原因停药；DOT为225 - 563 +），2名病情进展（DOT分别为285和532）。尽管样本量较小，Kaplan-Meier分析显示广泛¹⁸F-FDG摄取、寡转移¹⁸F-FDG摄取和非¹⁸F-FDG摄取疾病男性的无进展生存期（PFS）存在显著差异（p < 0.01）。所有男性均患有¹⁸F-NaF摄取性疾病。¹⁸F-NaF摄取性疾病的范围和强度均不能预测治疗反应。在接受阿比特龙和卡博替尼治疗的mCRPC男性中，¹⁸F-FDG-PET/CT可能优于¹⁸F-NaF-PET/CT和标准成像。¹⁸F-FDG-PET/CT可能有潜力将男性分为3组（广泛¹⁸F-FDG摄取性与寡转移¹⁸F-FDG摄取性与非¹⁸F-FDG摄取性mCRPC）以指导治疗。有必要进行进一步评估。
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