From the Department of Nuclear Medicine, The Royal Melbourne Hospital, Parkville, Victoria.
GenesisCare Theranostics, North Shore Health Hub, St Leonards, New South Wales.
Clin Nucl Med. 2024 Oct 1;49(10):966-967. doi: 10.1097/RLU.0000000000005390. Epub 2024 Aug 1.
A patient with widespread intensely prostate-specific membrane antigen-expressing, BRCA gene mutation-positive bone metastases at the time of prostate cancer diagnosis had progressed on multiple lines of standard therapy. He received 177 Lu-prostate-specific membrane antigen 8.5 GBq augmented by a short course of olaparib radiosensitization and achieved 90% decrease in serum PSA level after a single treatment. His tumor response was much better than expected by predictive dosimetry. However, his marrow radiotoxicity was worse than anticipated and required hospitalization. This suggests radiosensitizing agents to be a double-edged sword that must be carefully considered and balanced during activity prescription.
一位患者在前列腺癌诊断时即出现广泛强烈表达前列腺特异性膜抗原、BRCA 基因突变阳性的骨转移，在经过多种标准治疗后病情进展。他接受了 177Lu-前列腺特异性膜抗原 8.5GBq 治疗，并辅以短疗程奥拉帕利增敏，单次治疗后血清 PSA 水平下降了 90%。他的肿瘤反应明显好于预测剂量学预期。然而，他的骨髓放射性毒性比预期的更严重，需要住院治疗。这表明增敏剂是一把双刃剑，在开具治疗方案时必须仔细考虑并权衡利弊。
