Impact of 68Ga-PSMA-11 PET on Management in Patients with Biochemically Recurrent Prostate Cancer
Impact of 68Ga-PSMA-11 PET on Management in Patients with Biochemically Recurrent Prostate Cancer
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DOI：
10.2967/jnumed.117.192476
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发表时间：
2017-12-01
影响因子：
9.3
通讯作者：
Carroll, Peter R.
中科院分区：
文献类型：
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作者：
Hope, Thomas A.;Aggarwal, Rahul;Carroll, Peter R.
本前瞻性研究的目的是评估Ga-68标记的前列腺特异性膜抗原（PSMA）-11 PET对生化复发性前列腺癌患者预期治疗的影响。研究方法：由转介提供者为使用Ga-68-PSMA-11 PET成像的生化复发患者填写成像前和成像后调查。本研究的入选标准是初始治疗后前列腺特异性抗原（PSA）倍增时间小于12个月（NCT 02611882）。在150名连续成像的患者中，完成了126项调查（84%的应答率）。将反应分类为重大变化、微小变化、无变化或未知变化。结果：Ga-68-PSMA-11 PET检测到103例患者（82%）患有疾病。根据调查结果，有67名患者（53.2%）的管理发生重大变化，8名患者（6.4%）发生轻微变化。导致管理变更的病例比例在基线PSA水平上无显著差异。在PSA水平低于0.2 ng/dL的患者中，7/12例患者在Ga-68-PSMA-11 PET上检测到疾病，其中5例患者的治疗发生重大变化。结论：Ga-68-PSMA-11 PET导致53%生化复发患者的治疗发生重大变化。进一步的研究是必要的，以调查是否PSMA为基础的管理策略，改善患者的结果。
The purpose of this prospective study was to estimate the effect of Ga-68-labeled prostate-specific membrane antigen (PSMA)-11 PET on the intended management of patients with biochemically recurrent prostate cancer. Methods: Pre-and postimaging surveys were filled out by the referring providers for patients with biochemical recurrence who were imaged using Ga-68-PSMA-11 PET. The inclusion criterion for this study was a prostate-specific antigen (PSA) doubling time of less than 12 mo after initial treatment (NCT02611882). Of the 150 consecutive patients imaged, 126 surveys were completed (84% response rate). The responses were categorized as major change, minor change, no change, or unknown change. Results: There were 103 patients (82%) with disease detected on Ga-68-PSMA-11 PET. On the basis of the survey results, there were 67 patients (53.2%) with major changes in management and 8 patients (6.4%) with minor changes. The proportion of cases resulting in a change in management did not significantly differ by baseline PSA level. In patients with PSA levels below 0.2 ng/dL, 7 of 12 patients had disease detected on Ga-68-PSMA-11 PET, 5 of whom had a major change in management. Conclusion: Ga-68-PSMA-11 PET resulted in a major change in management in 53% of patients with biochemical recurrence. Further studies are warranted to investigate whether PSMA-based management strategies result in improved outcomes for patients.