The Impact of Positron Emission Tomography with 18F-Fluciclovine on the Treatment of Biochemical Recurrence of Prostate Cancer: Results from the LOCATE Trial.
The Impact of Positron Emission Tomography with 18F-Fluciclovine on the Treatment of Biochemical Recurrence of Prostate Cancer: Results from the LOCATE Trial.
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DOI：
10.1016/j.juro.2018.08.050
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发表时间：
2019-03
期刊：
影响因子：
--
通讯作者：
LOCATE Study Group
中科院分区：
文献类型：
--
作者：
Andriole GL;Kostakoglu L;Chau A;Duan F;Mahmood U;Mankoff DA;Schuster DM;Siegel BA;LOCATE Study Group
这项前瞻性的多中心试验(前列腺癌首次治疗后PSA升高的患者的18F-FLuciclovine[FACBC]PET/CT)评估了正电子发射断层扫描/18F-Fucicloine的计算机断层扫描对前列腺癌初次治疗后生化复发患者治疗计划的影响。那些接受过组织学确诊的前列腺癌的治疗意向治疗，但因前列腺特异性抗原水平升高而被怀疑复发的男性被纳入前瞻性研究。每个人在护理成像标准上都有阴性或模棱两可的发现。18F-氟西林正电子发射断层扫描/计算机断层扫描均按标准化方案进行。治疗医生在扫描前和扫描后填写一份关于患者治疗计划的问卷，主要记录治疗方式的变化(如挽救放射治疗到全身性雄激素剥夺治疗)，以及记录治疗方式的变化(如改良的放射治疗野)。在2016年6月至2017年5月期间，213名可评估的患者进入研究，这些患者的平均年龄为67岁，前列腺特异性抗原的中位数为1.00 ng/ml。在213例患者中，122例(57%)检出18F-氟尿嘧啶阳性病灶。总的来说，在213名患者中，有126名(59%)在扫描后发生了管理上的变化，其中98名(78%)和88名(70%)通过正电子发射断层扫描/计算机断层扫描的阳性发现进行了主要改变。最常见的变化是从抢救或非根治性系统治疗到警惕等待(32/126例，占25%)，从非根治性系统治疗到抢救治疗(30/126例，占24%)，从挽救治疗到非根治性系统治疗(11/126，占9%)。18F-荧光素正电子发射断层扫描/计算机断层扫描在大多数生化复发的男性中发现一个或多个复发部位，经常导致管理计划的重大变化。未来将计划进行研究，以确定管理层变动是否会带来更好的结果。
The prospective, multicenter LOCATE (18F Fluciclovine [FACBC] PET/ CT in Patients with Rising PSA after Initial Prostate Cancer Treatment) trial assessed the impact of positron emission tomography/computerized tomography with 18F-fluciclovine on treatment plans in patients with biochemical recurrence of prostate cancer after primary therapy with curative intent. Men who had undergone curative intent treatment of histologically confirmed prostate cancer but who were suspected to have recurrence based on rising prostate specific antigen levels were enrolled prospectively. Each man had negative or equivocal findings on standard of care imaging. 18F-fluciclovine positron emission tomography/computerized tomography was performed according to standardized protocols. Treating physicians completed a questionnaire regarding the patient treatment plan before and after scanning, recording changes to the treatment modality (eg salvage radiotherapy to systemic androgen deprivation therapy) as major and changes in a modality (eg modified radiotherapy fields) as other. Between June 2016 and May 2017, 213 evaluable patients with a median age of 67 years and median prostate specific antigen 1.00 ng/ml were enrolled in study. 18F-fluciclovine avid lesions were detected in 122 of the 213 patients (57%). Overall 126 of the 213 patients (59%) had a change in management after the scan, which were major in 98 of 126 (78%) and in 88 (70%) were informed by positive positron emission tomography/computerized tomography findings. The most frequent major changes were from salvage or noncurative systemic therapy to watchful waiting (32 of 126 cases or 25%), from noncurative systemic therapy to salvage therapy (30 of 126 or 24%) and from salvage therapy to noncurative systemic therapy (11 of 126 or 9%). 18F-fluciclovine positron emission tomography/computerized tomography detected 1 or more recurrence sites in the majority of men with biochemical recurrence, frequently resulting in major changes to management plans. Future studies will be planned to determine whether a management change leads to improved outcomes.
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期刊：
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影响因子：
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