简讯
背景:在重发性前列腺癌寡头瘤患者中,标准治疗是无色素疗法。 然而,ADT具有许多潜在的副作用,可能导致生活质量受损。 及早确定哪些患者适合进行立体疗程(SABR),对于防止或推迟启动ADT及其副作用至关重要.
由于前列腺-特定膜-抗原-11-聚氨酯排放托姆学(PSMA-11-PET)的灵敏度高于胆碱-PET,因此我们假设PSMA-11-PET基于SABR的结果是反应时间更长,随后启动ADT的时间也比胆碱-PET更长.
方法
Patients with oligometastatic (≤4 metastases) recurrent prostate cancer (with no local recurrence) based on PSMA-11-PET or choline-PET treated with SABR from January 2012 until December 2017 were included. Primary endpoint was ADT-free survival. Secondary endpoints were Prostate Specific Antigen (PSA) response after SABR and time to PSA rise after SABR.
结果:包括50名病人(n = 40 PSMA-11-PET和n = 10 胆碱-PET),共计72次损伤。 中间后续行动为24.3个月。 PSMA-11-PET使PSA水平低于胆碱酯酶-PET的患者获得了资格(中间值1.8对4.2纳克/毫升,p=0.03)。 PSMA-11-PET小组的PSA响应时间长得多(中位数34.0个月(95% 置信间隔(CI),16.0–52.0),对14.7个月(95% CI 4.7–24.7),p=0.04),随后ADT无生存时间长(中位数32.7个月(95% CI,20.8–44.5),对14.9个月(95% CI,5.7–24.1),p=0.01).
结 论
有了PSMA-11-PET,我们就可以在更早的疾病阶段,在低PSA水平上选择适合SABR的寡聚氨酯复发性前列腺癌患者。 PSMA-11-PET制导的SABR导致与胆碱-PET相比反应时间和ADT无生存能力显著延长,因此可以防止或延迟ADT相关副作用.
