Liu Wei, Loblaw Andrew, Laidley David, Fakir Hatim, Mendez Lucas, Davidson Melanie, Kassam Zahra, Lee Ting-Yim, Ward Aaron, Thiessen Jonathan, Bayani Jane, Conyngham John, Bailey Laura, Andrews Joseph D, Bauman Glenn
Department of Oncology, Division of Radiation Oncology, London Health Sciences Centre and Western University, London, ON, Canada.
Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre and Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Front Oncol. 2022 Apr 13;12:863848. doi: 10.3389/fonc.2022.863848. eCollection 2022.
Advances in imaging have changed prostate radiotherapy through improved biochemical control from focal boost and improved detection of recurrence. These advances are reviewed in the context of prostate stereotactic body radiation therapy (SBRT) and the ARGOS/CLIMBER trial protocol. ARGOS/CLIMBER will evaluate 1) the safety and feasibility of SBRT with focal boost guided by multiparametric MRI (mpMRI) and F-PSMA-1007 PET and 2) imaging and laboratory biomarkers for response to SBRT. To date, response to prostate SBRT is most commonly evaluated using the Phoenix Criteria for biochemical failure. The drawbacks of this approach include lack of lesion identification, a high false-positive rate, and delay in identifying treatment failure. Patients in ARGOS/CLIMBER will receive dynamic F-PSMA-1007 PET and mpMRI prior to SBRT for treatment planning and at 6 and 24 months after SBRT to assess response. Imaging findings will be correlated with prostate-specific antigen (PSA) and biopsy results, with the goal of early, non-invasive, and accurate identification of treatment failure.
影像学的进展通过聚焦加量改善生化控制以及改善复发检测，改变了前列腺癌放射治疗。本文结合前列腺立体定向体部放射治疗（SBRT）和ARGOS/CLIMBER试验方案对这些进展进行综述。ARGOS/CLIMBER将评估：1）在多参数MRI（mpMRI）和F-PSMA-1007 PET引导下进行聚焦加量的SBRT的安全性和可行性；2）SBRT反应的影像学和实验室生物标志物。迄今为止，前列腺SBRT的反应最常用Phoenix生化失败标准进行评估。这种方法的缺点包括无法识别病变、假阳性率高以及识别治疗失败延迟。ARGOS/CLIMBER试验的患者将在SBRT前接受动态F-PSMA-1007 PET和mpMRI以进行治疗计划，并在SBRT后6个月和24个月接受检查以评估反应。影像学结果将与前列腺特异性抗原（PSA）和活检结果相关联，目标是早期、非侵入性且准确地识别治疗失败。
