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  7. Oncology And Carcinogenesis
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  11. Flare Phenomenon Visualized By 99mtc-bone Scintigraphy Has Prognostic Value For Patients With Metastatic Castration-resistant Prostate Cancer

Flare phenomenon visualized by 99mTc-bone scintigraphy has prognostic value for patients with metastatic castration-resistant prostate cancer

Xue Zhang1, Kenichi Nakajima2, Atsushi Mizokami3

  • 1Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan.

Annals of Nuclear Medicine
|March 13, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

The flare phenomenon in metastatic castration-resistant prostate cancer (mCRPC) patients indicates a favorable prognosis. Bone scintigraphy every 3 months can help predict outcomes in mCRPC with bone metastasis.

Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiology

Background:

  • Metastatic castration-resistant prostate cancer (mCRPC) poses significant treatment challenges.
  • Prognostic markers are crucial for guiding therapeutic strategies in mCRPC.
  • The flare phenomenon, observed on bone scintigraphy, warrants further investigation as a prognostic indicator.

Purpose of the Study:

  • To evaluate the prognostic significance of the flare phenomenon in mCRPC patients.
  • To assess the role of the bone scan index (BSI) in conjunction with the flare phenomenon.
  • To determine if flare impacts survival outcomes in mCRPC treated with docetaxel.

Main Methods:

  • Retrospective analysis of 72 mCRPC patients from the PROSTAT-BSI registry.
  • Categorization based on pre-chemotherapy bone scan index (BSI) values.
Keywords:
BiomarkerBone scan indexChemotherapyMulticenter study

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  • Assessment of the flare phenomenon (defined as >10% BSI increase followed by >10% improvement within 6 months) and its impact on survival using Kaplan-Meier curves and Cox regression.

    • Main Results:

    • The flare phenomenon was observed in 36% of patients.
    • Patients without flare showed poor 2-year overall survival, influenced by BSI and PSA levels at 3 months.
    • Increased baseline BSI and PSA were independent risk factors for poor survival in non-flare patients, but lost significance during flare. Flare positively impacted survival (HR 0.24).

    Conclusions:

    • The flare phenomenon in mCRPC patients is associated with a favorable prognosis.
    • Flare phenomenon reduces the impact of other prognostic factors like PSA and BSI.
    • Regular bone scintigraphy (every 3 months) is recommended for prognosis assessment in mCRPC with bone metastases.
    Prognosis