Nuclear Medicine Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
Nuclear Medicine Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.
J Nucl Med. 2019 Oct;60(10):1388-1393. doi: 10.2967/jnumed.119.226449. Epub 2019 Mar 8.
Recent years have seen the start of treatment of metastatic castration-resistant prostate cancer with prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (PRLT), especially Lu-PSMA-617. However, PRLT has side effects on the salivary glands that limit the safety of the treatment. The current study aimed to show the effect of external cooling with ice packs on Lu-PSMA-617 uptake by the parotid glands (PGs). The study included 19 patients (mean age, 72.9 y) with metastatic castration-resistant prostate cancer who had been referred for the first time for Lu-PSMA-617 treatment and underwent pretreatment Ga-PSMA-11 PET/CT. Before the initiation of PRLT, the SUV and SUV of the right and left PGs were measured on Ga-PSMA PET/CT. Frozen ice packs were then affixed over the right PG of each patient for approximately 5 h; 1 h after they were affixed, PRLT was administered. At 4 h after PRLT, head-and-neck SPECT/CT was performed, and at both 4 and 24 h after PRLT, whole-body planar scintigraphy was performed. Regions and volumes of interest were applied for the right and left PGs, and the counts and volumes were determined. Before PRLT, Ga-PSMA-11 PET/CT showed no significant difference in SUV or SUV between the right and left PGs ( > 0.05). At 4 and 24 h after PRLT, planar imaging showed no significant difference in counts between the cooled and noncooled PGs ( > 0.05). Furthermore, at 4 h after PRLT, SPECT/CT showed no significant difference in counts or volumes between the cooled and noncooled PGs ( > 0.05). External cooling does not reduce uptake of Lu-PSMA-617 by the PGs.
近年来，针对去势抵抗性前列腺癌的转移灶，已经开始采用前列腺特异性膜抗原（PSMA）靶向放射性配体疗法（PRLT）进行治疗，尤其是 Lu-PSMA-617。然而，PRLT 会对唾液腺产生副作用，从而限制了治疗的安全性。本研究旨在观察冰袋外部冷却对腮腺（PGs）摄取 Lu-PSMA-617 的影响。
研究纳入了 19 例（平均年龄 72.9 岁）首次接受 Lu-PSMA-617 治疗的转移性去势抵抗性前列腺癌患者，所有患者均在治疗前进行了 Ga-PSMA-11 PET/CT 检查。在开始 PRLT 治疗之前，在 Ga-PSMA PET/CT 上测量了右侧和左侧 PG 的 SUV 和 SUV。然后，将每个患者右侧 PG 上的冷冻冰袋固定约 5 小时；固定 1 小时后，开始给予 PRLT。在 PRLT 后 4 小时，进行头颈部 SPECT/CT 检查，在 PRLT 后 4 小时和 24 小时，进行全身平面闪烁显像。对右侧和左侧 PG 应用感兴趣区，确定计数和体积。
在 PRLT 之前，Ga-PSMA-11 PET/CT 显示右侧和左侧 PG 的 SUV 或 SUV 之间没有显著差异（>0.05）。在 PRLT 后 4 小时和 24 小时，平面成像显示冷却和未冷却 PG 之间的计数没有显著差异（>0.05）。此外，在 PRLT 后 4 小时，SPECT/CT 显示冷却和未冷却 PG 之间的计数或体积没有显著差异（>0.05）。
外部冷却不会减少 Lu-PSMA-617 对 PG 的摄取。
