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在PSMA-PET和MR引导前列腺SBRT后PSA和PSMA动力学与焦点增强:来自II期PROBE试验的结果

Maneesh Singh¹, Suchismita Ghosh², Aparna Katdare³

¹Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute, Mumbai, India.

International journal of radiation oncology, biology, physics

|February 27, 2026

概括

接受PSMA-PET/MR引导的SBRT和ADT治疗的高风险前列腺癌患者实现了深度PSA nadirs和逐渐的PSMA动力学. 超过80%的患者在6个月内达到PSA<0.1 ng/ml,其中三分之二的患者在12个月内达到完全反应.

科学领域:

在瘤学瘤学.
放射疗法是一种放射治疗.
核医学是一种核医学.

背景情况:

局部性前列腺癌需要有效的治疗策略.
前列腺特异性膜抗原 (PSMA) PET和MRI是先进的成像方式.
与雄激素剥夺疗法 (ADT) 结合的立体体辐射疗法 (SBRT) 是一种治疗选择.

研究的目的:

为了评估前列腺特异性抗原 (PSA) 和PSMA动力学后PSMA-PET和MR引导的SBRT与主导性前列腺内病变 (DIL) 提升和短期ADT.
评估局部前列腺癌患者的治疗反应和毒性.

主要方法:

一项涉及中等和高风险前列腺癌患者的II期试验的预先规定的分析.
患者接受了五分数SBRT与DIL增强和6个月的ADT.
每3个月对PSA水平进行监测,并使用68Ga-PSMA-PET/CT在SBRT后的各种时间点评估纵向代谢反应.

主要成果:

79%的患者在6个月后达到PSA<0.1 ng/ml,在12个月后达到50%.
平均SUVmax在治疗后显著下降,完全响应 (CR) 率在12个月后增加到65%.
没有观察到CTCAE等级≥3的生殖尿道/胃肠道毒性.

结论:

带有DIL提升的PSMA-PET和MR引导的SBRT显示出有利的PSA和PSMA动力学以及良好的安全性.
在6个月内达到PSA<0.1 ng/ml可能预测完全反应.
早期的PSMA完全反应可以作为局部前列腺癌风险适应策略的生物标志物.

关键词:

主导性前列腺内损伤焦点提升焦点提升 PSA 的动力学,PSMA 的动力学.前列腺癌是前列腺癌.在SBRT和SBRT之间.

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