Alberto Matthew, Yim Arthur, Papa Nathan, Siva Shankar, Ischia Joseph, Touijer Karim, Eastham James A, Bolton Damien, Perera Marlon
Department of Surgery, Austin Health, University of Melbourne, Melbourne, VIC, Australia.
Department of Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Front Oncol. 2022 Aug 18;12:929444. doi: 10.3389/fonc.2022.929444. eCollection 2022.
Oligometastatic prostate cancer (OMPC) has been proposed as an intermediary state between localised disease and widespread metastases, with varying definitions including 1, 3, or ≤5 visceral or bone metastasis. Traditional definitions of OMPC are based on staging with conventional imaging, such as computerised tomography (CT) and whole-body bone scan (WBBS). Novel imaging modalities such as prostate-specific membrane antigen positron emission tomography (PSMA PET) have improved diagnostic utility in detecting early metastatic prostate cancer (PC) metastases compared with conventional imaging. Specifically, meta-analytical data suggest that PSMA PET is sensitive in detecting oligometastatic disease in patients with biochemical recurrence (BCR) post-radical treatment of PC. Recent trials have evaluated PSMA PET-guided metastases-directed therapy (MDT) in oligometastatic recurrent disease, typically with salvage surgery or radiotherapy (RT). To date, these preliminary studies demonstrate promising results, potentially delaying the need for systemic therapy. We aim to report a comprehensive, multidisciplinary review of PSMA-guided MDT in OMPC. In this review, we highlight the utility of PMSA PET in biochemically recurrent disease and impact of PSMA PET on the definition of oligometastatic disease and outline data pertaining to PSMA-guided MDT.
寡转移前列腺癌（OMPC）被认为是局限性疾病和广泛转移之间的一种中间状态，其定义各异，包括1个、3个或≤5个内脏或骨转移灶。OMPC的传统定义基于传统成像技术（如计算机断层扫描（CT）和全身骨扫描（WBBS））进行分期。与传统成像相比，前列腺特异性膜抗原正电子发射断层扫描（PSMA PET）等新型成像方式在检测早期转移性前列腺癌（PC）转移灶方面具有更高的诊断效用。具体而言，荟萃分析数据表明，PSMA PET在检测PC根治性治疗后生化复发（BCR）患者的寡转移疾病方面具有较高的敏感性。近期试验评估了PSMA PET引导下的转移灶定向治疗（MDT）在寡转移复发性疾病中的应用，通常采用挽救性手术或放疗（RT）。迄今为止，这些初步研究显示出了有前景的结果，可能会推迟全身治疗的需求。我们旨在报告一项关于PSMA引导下OMPC的MDT的全面、多学科综述。在本综述中，我们强调了PMSA PET在生化复发疾病中的效用以及PSMA PET对寡转移疾病定义的影响，并概述了与PSMA引导下MDT相关的数据。
