Couñago Felipe, Martínez-Ballesteros Claudio, Artigas Carlos, Díaz-Gavela Ana Aurora, Gómez Luis Leonardo Guerrero, Lillo-García María Eugenia, Chicharo José Reinaldo, Recio Manuel, Maldonado Antonio, Thuissard Israel J, Andreu-Vázquez Cristina, Sanz-Rosa David, Conde-Moreno Antonio José, Marcos Francisco José, García Sofía Sánchez, Martínez-Salamanca Juan Ignacio, Carballido-Rodríguez Joaquin, Hornedo Javier, Cerro Elia Del
Department of Radiation Oncology, Hospital Universitario Quirónsalud Madrid, 28223 Pozuelo de Alarcón, Madrid, Spain.
Department of Radiation Oncology, Hospital La Luz, Madrid, 28003, Spain.
Rep Pract Oncol Radiother. 2020 May-Jun;25(3):405-411. doi: 10.1016/j.rpor.2020.03.024. Epub 2020 Apr 12.
To evaluate whether positron-emission tomography/computed tomography with Ga-PSMA (Ga-PSMA PET/CT) influences the therapeutic management of patients with primary or recurrent prostate cancer (PCa).
Although Ga-PSMA PET/CT is one of the best options for staging or restaging patients with PCa, its availability is still very limited in Spain. The present study reports the results of the first group of patients in Spain who underwent Ga-PSMA PET/CT imaging.
All patients (n = 27) with a histological diagnosis of PCa who underwent Ga-PSMA PET/CT prior to the definitive treatment decision at the only centre with this technology in Spain during 2017-2018 were included. Two nuclear medicine physicians and a radiologist reviewed the imaging studies. The clinical impact was assessed from a theoretical perspective, based on the treatment that would have been applied if no data from the Ga-PSMA PET/CT were available.
Most patients (n = 26; 96%) had persistent disease or biochemical recurrence after radical prostatectomy, radiotherapy, or combined treatment. One patient underwent Ga-PSMA PET/CT imaging to stage high-risk PCa. Overall, Ga-PSMA PET/CT was positive in 19 patients (70.4%). In 68.75% of these patients, none of the other imaging tests-MRI, CT, or bone scans-performed prior to the Ga-PSMA PET/CT were able to detect the presence of cancerous lesions. Overall, the findings of the Ga-PSMA PET/CT led to a modification of the therapeutic approach in 62.96% of the patients in the study.
Ga-PSMA PET/CT alters the therapeutic approach in a substantial proportion of patients with PCa.
评估镓-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描（Ga-PSMA PET/CT）是否会影响原发性或复发性前列腺癌（PCa）患者的治疗管理。
尽管Ga-PSMA PET/CT是对PCa患者进行分期或重新分期的最佳选择之一，但在西班牙其可用性仍然非常有限。本研究报告了西班牙第一组接受Ga-PSMA PET/CT成像的患者的结果。
纳入2017年至2018年期间在西班牙唯一拥有该技术的中心，在确定最终治疗方案之前接受Ga-PSMA PET/CT检查的所有经组织学诊断为PCa的患者（n = 27）。两名核医学医师和一名放射科医生对影像研究进行了审查。基于如果没有Ga-PSMA PET/CT数据时原本会采用的治疗方法，从理论角度评估了临床影响。
大多数患者（n = 26；96%）在根治性前列腺切除术、放疗或联合治疗后患有持续性疾病或生化复发。一名患者接受Ga-PSMA PET/CT成像以对高危PCa进行分期。总体而言，19名患者（70.4%）的Ga-PSMA PET/CT呈阳性。在这些患者中，68.75%在Ga-PSMA PET/CT之前进行的其他影像学检查（MRI、CT或骨扫描）均未能检测到癌性病变的存在。总体而言，Ga-PSMA PET/CT的检查结果导致本研究中62.96%的患者的治疗方法发生了改变。
Ga-PSMA PET/CT在很大一部分PCa患者中改变了治疗方法。
