PSMA-PET/CT response after metastasis-directed radiotherapy of bone oligometastases in prostate cancer.

Autor: Sheikh GT; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. Gabriel.Sheikh@med.uni-muenchen.de., Trapp C; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany., Schmidt-Hegemann NS; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany., Buchner A; Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany., Stief CG; Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany., Unterrainer M; Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany., Kunz WG; Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany., Cyran CC; Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany., Grawe F; German Cancer Research Center (DKFZ), Hector Cancer Institute at the University Medical Center Mannheim, Heidelberg, Germany.; Department of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany., Delker A; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany., Zacherl MJ; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany., Holzgreve A; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany., Unterrainer LM; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.; Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, USA., Brendel M; Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany., Belka C; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany.; German Cancer Consortium (DKTK), Heidelberg, Germany., Li M; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany., Rogowski P; Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany.
Jazyk: angličtina
Zdroj: EJNMMI reports [EJNMMI Rep] 2024 Aug 19; Vol. 8 (1), pp. 25. Date of Electronic Publication: 2024 Aug 19.
DOI: 10.1186/s41824-024-00212-w
Abstrakt: Objective: Bone metastases are very common in advanced prostate cancer and can sensitively be detected utilizing PSMA-PET/CT. Therefore, our goal was to evaluate the suitability of PSMA-PET/CT-guided metastasis-directed external beam radiotherapy (MDT) as treatment option for patients with biochemical recurrence and oligometastatic bone lesions.
Materials & Methods: We retrospectively examined 32 prostate cancer patients with biochemical recurrence and PSMA-positive oligometastatic disease limited to the bone (n = 1-3). A total of 49 bone lesions were treated with MDT. All patients received a post-radiotherapy PSMA-PET/CT-Scan. Changes in SUV max , PSMA-positive tumor volume per lesion and PSA, as well as the correlation between the PET/CT-interval and SUV max response were calculated.
Results: MDT lead to a SUV max decrease in 46/49 (94%) of the lesions. The median relative decline of SUV max was 60.4%, respectively. Based on PSMA-positive lesion volume with a SUV cut-off of 4, 46/49 (94%) of lesions showed complete response, two (4%) partial response and one lesion (2%) was stable on PSMA-PET/CT after MDT. Most of the treated patients (56.3%) showed an initial PSA decline at three months and a PSA nadir of median 0.14 ng/ml after a median time of 3.6 months after MDT. The median relative PSA change at three months after MDT was 3.9%.
Conclusion: MDT is a very effective treatment modality for prostate cancer bone oligometastases and lesion response to MDT can be assessed using the (semi-)quantitative parameters SUV max and PSMA-positive lesion volume with established SUV cut-offs.
(© 2024. The Author(s).)
Databáze: MEDLINE
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