Impact of 68Ga-PSMA-11 PET/CT on the Management of Prostate Cancer Patients with Biochemical Recurrence
Impact of 68Ga-PSMA-11 PET/CT on the Management of Prostate Cancer Patients with Biochemical Recurrence
复制标题
DOI：
10.2967/jnumed.117.202945
复制
发表时间：
2018-03-01
影响因子：
9.3
通讯作者：
Herrmann, Ken
中科院分区：
文献类型：
--
作者：
Calais, Jeremie;Fendler, Wolfgang P.;Herrmann, Ken
在这项对转诊医生的前瞻性调查中，我们调查了Ga-68标记的前列腺特异性膜抗原11（Ga-68-PSMA-11）PET/CT是否以及如何影响生化复发（BCR）的前列腺癌患者的实施管理。研究方法：我们对转诊的161例前列腺癌BCR患者（中位前列腺特异性抗原值，1.7 ng/mL;范围，0.05-202 ng/mL）的医生进行了一项前瞻性调查（NCT 02940262）。转诊医生在扫描前完成一份调查问卷，以表明治疗计划，但不含Ga-68-PSMA-11 PET/CT信息（Q1; n = 101），在扫描后立即完成一份调查问卷，以表明预期的管理变更（Q2; n = 101），在3-6个月后完成一份调查问卷，以记录最终实施的管理（Q3; n = 56）。还通过电子病历审查或患者联系获得了实施的管理（n = 45）。结果：161例患者中有101例（63%）提供了完整的记录管理策略（Q1 1 Q2 1实施管理）。其中76例（75%）的Ga-68-PSMA-11 PET/CT结果为阳性。101例患者中有54例（53%）实施的管理与预扫描预期管理（Q1）不同。101例患者中有62例（61%）的扫描后预期管理（Q2）与扫描前预期管理（Q1）不同;然而，62例患者中有29例（47%）未实施这些预期变更。Ga-68-PSMA-11 PET/CT显示的盆腔淋巴结和盆腔外转移性疾病（PSMA T0 N1 M0和PSMA T0 N1 M1模式）与实施的管理变化显著相关（P = 0.001和0.05）。结论：来自Ga-68-PSMA-11 PET/CT的信息使超过50%的BCR前列腺癌患者（54/101; 53%）的管理发生变化。然而，Ga-68-PSMA-11 PET/CT后早期预期的管理变更通常与实施的管理变更不同。
In this prospective survey of referring physicians, we investigated whether and how Ga-68-labeled prostate-specific membrane antigen 11 (Ga-68-PSMA-11) PET/CT affects the implemented management of prostate cancer patients with biochemical recurrence (BCR). Methods: We conducted a prospective survey of physicians (NCT02940262) who referred 161 patients with prostate cancer BCR (median prostate-specific antigen value, 1.7 ng/mL; range, 0.05-202 ng/mL). Referring physicians completed one questionnaire before the scan to indicate the treatment plan without Ga-68-PSMA-11 PET/CT information (Q1; n = 101), one immediately after the scan to denote intended management changes (Q2; n = 101), and one 3-6 mo later to document the final implemented management (Q3; n = 56). The implemented management was also obtained via electronic chart review or patient contact (n = 45). Results: A complete documented management strategy (Q1 1 Q2 1 implemented management) was available for 101 of 161 patients (63%). Seventy-six of these (75%) had a positive Ga-68-PSMA-11 PET/CT result. The implemented management differed from the prescan intended management (Q1) in 54 of 101 patients (53%). The postscan intended management (Q2) differed from the prescan intended management (Q1) in 62 of 101 patients (61%); however, these intended changes were not implemented in 29 of 62 patients (47%). Pelvic nodal and extrapelvic metastatic disease on Ga-68-PSMA-11 PET/CT (PSMA T0N1M0 and PSMA T0N1M1 patterns) was significantly associated with implemented management changes (P = 0.001 and 0.05). Conclusion: Information from Ga-68-PSMA-11 PET/CT brings about management changes in more than 50% of prostate cancer patients with BCR (54/101; 53%). However, intended management changes early after Ga-68-PSMA-11 PET/CT frequently differ from implemented management changes.