Health Sciences University, Okmeydanı Training and Research Hospital, Department of Nuclear Medicine, İstanbul, Turquía.
Health Sciences University, Okmeydanı Training and Research Hospital, Department of Nuclear Medicine, İstanbul, Turquía.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2020 Sep-Oct;39(5):292-298. doi: 10.1016/j.remn.2020.01.004. Epub 2020 Jun 25.
There have been only few studies investigating the role of PSMA ligands in the therapy response assessment of metastasized castration resistant prostate cancer (mCRPC) cases. In this study we aimed at evaluating the capability of Ga- prostate-specific membrane antigen (PSMA) I&T positron emission tomography/computerized tomography (PET/CT) in the assessment of therapeutic response in patients under docetaxel therapy for prostate cancer (PCa).
The clinical records of all mCRPC patients treated with docetaxel and referred to our department for Ga-PSMA I&T PET/CT imaging were retrospectively analysed. Sixteen patients (mean age 69 years, range 52-82 years) with castration-resistant prostate cancer patients receiving palliative docetaxel therapy and had undergone Ga-PSMA I&T PET/CT scan were included in the study. Ga-PSMA I&T PET/CT imaging was done and prostate specific antigen (PSA) levels were measured at baseline before administration of docetaxel (PET1) and after at least 3 cycles (range 4-12) of chemotherapy (PET2). Patient-based as well as lesion-based comparison of PET2 findings with PET1 findings were done.
The change (decrease) observed in lymph node and prostate gland/prostatic bed SUVmax values after treatment compared to pretreatment was found to be statistically significant (P=.033). 3/16 patients (19%) were classified as progressive disease (PD), 4/16 (25%) as stable disease (SD), 9/16 (56%) as partial remission (PR) radiologically. An increasing PSA trend (IT) was observed in 4 patients (25%) and a decreasing PSA trend (DT) in 3 patients (18%). Nine patients showed a PSA response of ≥ 50% (56%). Of the 4 patients showing SD, 3 had IT, 3 had BR. Of the 9 patients who showed PR on PET studies, 8 patients showed BR and 1 patient showed DT.
Imaging with Ga-PSMA PET/CT showed great concordance with biochemical response evaluation in terms of PSA levels, especially in patients showing good response to therapy. Ga-PSMA PET/CT was also successful in identifying progressive disease in patients showing paradoxical decline in PSA levels.
仅有少数研究调查了 PSMA 配体在转移性去势抵抗性前列腺癌（mCRPC）病例治疗反应评估中的作用。在这项研究中，我们旨在评估 Ga-前列腺特异性膜抗原（PSMA）I&T 正电子发射断层扫描/计算机断层扫描（PET/CT）在接受多西他赛治疗的前列腺癌（PCa）患者治疗反应评估中的能力。
回顾性分析了所有接受多西他赛治疗并转至我科行 Ga-PSMA I&T PET/CT 成像的 mCRPC 患者的临床记录。本研究纳入了 16 例接受姑息性多西他赛治疗且接受 Ga-PSMA I&T PET/CT 扫描的去势抵抗性前列腺癌患者（平均年龄 69 岁，范围 52-82 岁）。在给予多西他赛之前（PET1）和至少 3 个周期（范围 4-12）化疗后（PET2）进行 Ga-PSMA I&T PET/CT 成像和前列腺特异性抗原（PSA）水平测量。对 PET2 与 PET1 结果进行基于患者和基于病变的比较。
治疗后与治疗前相比，淋巴结和前列腺/前列腺床 SUVmax 值的变化（减少）具有统计学意义（P=.033）。3/16 例患者（19%）为进展性疾病（PD），4/16 例（25%）为稳定疾病（SD），9/16 例（56%）为部分缓解（PR）。4 例患者（25%）出现 PSA 趋势升高（IT），3 例患者（18%）出现 PSA 趋势降低（DT）。9 例患者 PSA 反应≥50%（56%）。在显示 SD 的 4 例患者中，3 例 IT，3 例 BR。在 PET 研究中显示 PR 的 9 例患者中，8 例 BR，1 例 DT。
Ga-PSMA PET/CT 成像在 PSA 水平方面与生化反应评估具有很好的一致性，尤其是在对治疗反应良好的患者中。Ga-PSMA PET/CT 还成功地在 PSA 水平呈反常下降的患者中识别出进行性疾病。
