医学
前列腺癌
泌尿科
内科学
转移
胃肠病学
可视模拟标度
进行性疾病
骨转移
肿瘤科
接收机工作特性
阶段(地层学)
前列腺特异性抗原
癌症
外科
化疗
古生物学
生物
作者
Manoj Gupta,Ganesan Karthikeyan,Partha Sarathi Choudhury,Anurag Sharma,Amitabh Singh,Sudhir Rawal
出处
期刊:Hellenic Journal of Nuclear Medicine
日期:2020-09-01
卷期号:23 (3): 312-320
被引量:5
标识
DOI:10.1967/s002449912219
摘要
Objective We analyzed the clinical outcome of lutetium-177 prostate-specific membrane antigen (177Lu-PSMA) in metastatic castration-resistant prostate cancer (mCRPC) patients with visceral metastasis. Subjects and methods Ten patients of mCRPC with visceral metastasis were enrolled for one cycle of 177Lu-PSMA therapy. Number of efficacy and safety parameters, e.g., prostate-specific antigen (PSA), visual analog scale (VAS) and analgesic quantification scale (AQS), hemoglobin (Hb), total leukocytes counts (TLC), platelets, creatinine, & total bilirubin, were assessed and compared with Wilcoxon signed-rank test. The progression-free survival (PFS) curve was computed by the Kaplan-Meier method. The receiver operating characteristic curve (ROC) was also plotted for 177Lu-PSMA dose. P≤0.05 was considered significant. Results Liver (80%), lung (30%), adrenal (10%), and peritoneum (10%) were the sites of visceral metastasis in our study. On PSA response assessment, 10%, 60%, and 30% of the patients had partial response, stable disease, and progressive disease, respectively. Forty percent of the patients had improvement in the VAS, while 50% had improvement in the AQS score. Median PFS was 24 weeks in our study. A cut-off of 4.88GBq of 177Lu-PSMA was the best-predicted progression with 66.67% sensitivity and 100% specificity on ROC analysis. Thirty percent of the patients showed grade 3 anemia. No other significant toxicity was seen. Conclusion Lutetium-177-PSMA was a reasonable palliative treatment option with limited toxicity for these end-stage mCRPC patients with visceral metastasis with adequate PSA stabilization. A synergistic drug amalgamation may be an ideal way to boost the outcome in the future.
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