Division of Nuclear Medicine, Department of Medical Imaging, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
Department of Radiation Oncology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
Ann Nucl Med. 2024 Jul;38(7):508-515. doi: 10.1007/s12149-024-01924-6. Epub 2024 Apr 22.
Radium-223 (Ra-223) is an important treatment modality for bone-dominant metastatic castration-resistant prostate cancer (mCRPC). However, there is currently a lack of effective markers to monitor treatment response during treatment. We aim to investigate the response in prostate-specific antigen doubling time (PSADT) as a potential marker for assessing Ra-223 treatment in mCRPC patients.
We retrospectively collected data from mCRPC patients who underwent radium treatment at our institution between August 2020 and June 2023. Prostate-specific antigen (PSA) measurements prior to treatment and during treatment were collected. Baseline PSADT was calculated from PSA measurements prior to Ra-223 treatment; interim PSADT was calculated from PSA measurements before Ra-223 treatment and prior to the fourth course injection. Overall survival was calculated from the start of treatment to the date of death. Univariable and multivariable analysis using the Cox proportional hazards model were performed to examine the association of factors with overall survival.
We included 35 patients from our institution, with a median overall survival of 13.3 months. Eighteen (51.4%) completed all six courses of treatment. PSA dynamic response (interim PSADT > baseline PSADT or decreased PSA) was observed in 20 patients. Overall survival was associated with a PSA dynamic response (HR = 0.318, 95% CI 0.133-0.762, p = 0.010) when compared to patients without response.
Dynamic changes in PSADT were associated with survival in mCRPC patients receiving radium therapy. Comparing interim and baseline PSADT could serve as a valuable marker for determining treatment benefits.
镭-223（Ra-223）是治疗骨转移去势抵抗性前列腺癌（mCRPC）的重要手段。然而，目前缺乏有效的标志物来监测治疗期间的治疗反应。我们旨在研究前列腺特异性抗原倍增时间（PSADT）的反应，作为评估 mCRPC 患者镭-223 治疗的潜在标志物。
我们回顾性收集了 2020 年 8 月至 2023 年 6 月期间在我院接受镭治疗的 mCRPC 患者的数据。收集了治疗前和治疗期间的前列腺特异性抗原（PSA）测量值。从 Ra-223 治疗前的 PSA 测量值计算基线 PSADT；从中期 PSADT 从 Ra-223 治疗前的 PSA 测量值和第四次疗程注射前的 PSA 测量值计算。从治疗开始到死亡日期计算总生存期。使用 Cox 比例风险模型进行单变量和多变量分析，以检查与总生存期相关的因素。
我们从本院纳入了 35 名患者，中位总生存期为 13.3 个月。18 名（51.4%）完成了所有六轮治疗。20 名患者观察到 PSA 动态反应（中期 PSADT＞基线 PSADT 或 PSA 降低）。与无反应的患者相比，PSA 动态反应（HR=0.318，95%CI 0.133-0.762，p=0.010）与总生存期相关。
接受镭治疗的 mCRPC 患者 PSADT 的动态变化与生存相关。比较中期和基线 PSADT 可能是确定治疗益处的有价值的标志物。
