Department of Radiation Oncology, London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada.
Departments of Medicine and Radiology, McMaster University, Ontario, Canada.
Expert Rev Anticancer Ther. 2021 Jun;21(6):641-655. doi: 10.1080/14737140.2021.1878883. Epub 2021 Feb 8.
PSMA-targeted PET/CT is a 'Next Generation Imaging' technique with superior sensitivity and specificity for detecting recurrent prostate cancer compared with conventional imaging, allowing more accurate staging and re-staging.
This article reviews the role of PSMA-targeted PET/CT in clinical management of men with recurrent prostate cancer.
Through enhanced spatial characterization of recurrent prostate cancer, PSMA-targeted PET/CT has shown significant impact on management decisions. In particular, by identifying men with recurrence confined to the prostate or pelvic nodes, PSMA-targeted PET/CT enables selective deployment of localized salvage therapies for management of biochemical failure after primary treatment with prostatectomy or radiotherapy. In oligometastatic disease, PSMA-targeted PET/CT may improve patient selection and treatment accuracy for metastasis-directed therapy and early phase II studies show encouraging results in delaying the need for systemic therapy. Further, quantitative PSMA-targeted PET/CT for monitoring response and therapeutic PSMA-targeted radiopharmaceuticals are emerging as encouraging treatment options in the setting of castrate-resistant disease.
与传统成像相比，PSMA 靶向 PET/CT 是一种“下一代成像”技术，在检测复发性前列腺癌方面具有更高的灵敏度和特异性，可实现更准确的分期和再分期。
本文综述了 PSMA 靶向 PET/CT 在复发性前列腺癌男性临床管理中的作用。
通过增强对复发性前列腺癌的空间特征描述，PSMA 靶向 PET/CT 对管理决策产生了重大影响。特别是，通过识别仅局限于前列腺或盆腔淋巴结的复发患者，PSMA 靶向 PET/CT 可选择性地对前列腺切除术或放疗后原发性治疗后生化失败的患者进行局部挽救性治疗。对于寡转移疾病，PSMA 靶向 PET/CT 可能会改善转移导向治疗的患者选择和治疗准确性，早期的 II 期研究结果令人鼓舞，可延迟对系统治疗的需求。此外，在去势抵抗性疾病背景下，定量 PSMA 靶向 PET/CT 用于监测反应和治疗性 PSMA 靶向放射性药物也正在成为令人鼓舞的治疗选择。
