von Eyben Finn Edler, Kairemo Kalevi, Kiljunen Timo, Joensuu Timo
Birkevej 17, DK-5230 Odense M, Denmark.
Curr Radiopharm. 2015;8(1):19-31. doi: 10.2174/1874471008666150316222203.
In this paper, we give an overview of articles on non-choline tracers for PET/CT for patients with prostate cancer and planning of radiotherapy guided by PET/CT. Nineteen articles described (11)C-Acetate PET/CT. Of 629 patients 483 (77%, 95% CI 74% - 80%) had positive (11)C-Acetate PET/CT scans. Five articles described (18)F-FACBC PET/CT. Of 174 patients, 127 (73%, 95% CI 68% - 78%) had positive scans. Both tracers detected local lesions, lesions in regional lymph nodes, and distant organs. Ten articles described (18)F-NaF PET/CT and found that 1289 of 3918 patients (33%) had positive reactive lesions in bones. PET/CT scan can guide external beam radiotherapy (EBRT) planning for patients with loco-regional prostate cancer. In six studies with 178 patients with localized prostate cancer, PET/CT pointed out dominant intraprostatic lesions (DIL). Oncologists gave EBRT to the whole prostate and a simultaneously integrated boost to the DIL. Four studies with 254 patients described planning of EBRT for patients with PETpositive lymph nodes. After the EBRT, 15 of 29 node-positive patients remained in remission for median 28 months (range 14 to 50 months). Most articles describe (11)C- and (18)F-Choline PET/CT. However, (11)C-Acetate and (18)F-FACBC may also be useful tracers for PET/CT. Planning of radiotherapy guided by MRI or PET/CT is an investigational method for localized prostate cancer. Current clinical controlled trials evaluate whether the method improves overall survival.
在本文中，我们对有关前列腺癌患者PET/CT非胆碱示踪剂及PET/CT引导下放射治疗计划的文章进行了综述。19篇文章描述了¹¹C-醋酸盐PET/CT。在629例患者中，483例（77%，95%CI 74% - 80%）¹¹C-醋酸盐PET/CT扫描呈阳性。5篇文章描述了¹⁸F-FACBC PET/CT。在174例患者中，127例（73%，95%CI 68% - 78%）扫描呈阳性。两种示踪剂均能检测到局部病变、区域淋巴结病变和远处器官病变。10篇文章描述了¹⁸F-NaF PET/CT，发现3918例患者中有1289例（33%）骨骼出现阳性反应性病变。PET/CT扫描可为局部前列腺癌患者的外照射放疗（EBRT）计划提供指导。在针对178例局限性前列腺癌患者的6项研究中，PET/CT指出了前列腺内主要病变（DIL）。肿瘤学家对整个前列腺进行EBRT，并同时对DIL进行同步加量照射。4项针对254例患者的研究描述了PET阳性淋巴结患者的EBRT计划。EBRT后，29例淋巴结阳性患者中有15例持续缓解，中位缓解时间为28个月（范围14至50个月）。大多数文章描述了¹¹C-和¹⁸F-胆碱PET/CT。然而，¹¹C-醋酸盐和¹⁸F-FACBC也可能是PET/CT的有用示踪剂。MRI或PET/CT引导下的放射治疗计划是局限性前列腺癌的一种研究方法。目前的临床对照试验正在评估该方法是否能提高总生存率。
