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早期治疗响应评估与[177 Lu]PSMA全身光学扫描相比,与临时PSMA-PET相比

David Ventura^1,2, Philipp Rassek^3,4, Philipp Schindler^4,5

¹Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. david.ventura@ukmuenster.de.

Cancer imaging : the official publication of the International Cancer Imaging Society

|September 19, 2024

概括

在接受放射性连接体治疗 (RLT) 的前列腺癌患者中,临时PET扫描和治疗后全身扫描 (WBS) 显示出高度一致. 使用这两种方法的早期反应评估可以预测转移性割抵抗性前列腺癌 (mCRPC) 的整体存活率 (OS).

科学领域:

在瘤学瘤学.
核医学就是核医学.
辐射疗法辐射疗法

背景情况:

前列腺特异性膜抗原正子发射断层扫描 (PSMA-PET) 对于前列腺癌的放射性对象治疗 (RLT) 期间的患者选择和监测至关重要.
与治疗后成像相比,PSMA-PET的临床实用性,用于评估RLT反应和患者的结果,仍在研究中.

研究的目的:

为了比较两轮RLT后的PSMA-PET中期扫描与治疗后全身扫描 (WBS) 在预测整体存活 (OS) 的有效性.
为了评估早期治疗反应评估的预后价值,在接受RLT的转移性割抵抗性前列腺癌 (mCRPC) 患者中.

主要方法:

在2015年2月至2021年12月期间,对188名mCRPC男性进行了RLT治疗的回顾性分析.
利用PROMISE V2框架进行PSMA表达分类和治疗响应评估,将响应定义为疾病控制率 (DCR) 或进展.
来自WBS和临时PSMA-PET的相关成像发现与整体存活率 (OS) 和前列腺特异性抗原 (PSA) 的下降.

主要成果:

在两个RLT周期后,观察到WBS和临时PSMA-PET对响应评估之间的强显著相关性 (克拉默V测试) (cφ = 0.888,P < 0.001).
通过WBS或临时PSMA-PET确定的早期进展与显著更短的OS相关 (WBS为15个月,P<0.001;PET为11个月,P<0.001).
在两个RLT周期后,PSA下降≥50%预测了死亡风险明显降低 (26个月与17个月相比,P<0.001).

结论:

在两个RLT周期后,使用WBS和临时PSMA-PET进行响应评估,显示出高一致性,并有效地识别出预后不佳的患者.
临时PSMA-PET可能会被遗漏用于对mCRPC的RLT响应评估,等待未来临床试验的确认.

关键词:

这就是PSMA-PET.放射性合物治疗是一种放射性合物治疗.在WBS中,WBS是WBS.[177Lu]PSMAMA的第一时间 mCRPC 的使用情况.

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