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Intra-therapeutic dosimetry of [(177)Lu]Lu-PSMA-617 in low-volume hormone-sensitive metastatic prostate cancer patients and correlation with treatment outcome

التفاصيل البيبلوغرافية
العنوان: Intra-therapeutic dosimetry of [(177)Lu]Lu-PSMA-617 in low-volume hormone-sensitive metastatic prostate cancer patients and correlation with treatment outcome
المؤلفون: Maarten de Bakker, Martin Gotthardt, Bastiaan M. Privé, Walter Jentzen, Mark Konijnenberg, Annemarie Eek, Steffie M. B. Peters, J. Alfred Witjes, Frank de Lange, James Nagarajah, Constantijn H.J. Muselaers, Niven Mehra
المساهمون: Radiotherapy, Radiology & Nuclear Medicine
المصدر: European Journal of Nuclear Medicine and Molecular Imaging, 49, 2, pp. 460-469
European Journal of Nuclear Medicine and Molecular Imaging, 49, 460-469
European Journal of Nuclear Medicine and Molecular Imaging, 49(2), 460-469. Springer-Verlag
European Journal of Nuclear Medicine and Molecular Imaging
سنة النشر: 2022
مصطلحات موضوعية: Male, Organs at Risk, medicine.medical_specialty, Single Photon Emission Computed Tomography Computed Tomography, Urology, Lutetium, Radionuclide therapy, Radiation Dosage, [177Lu]Lu-PSMA, 030218 nuclear medicine & medical imaging, Lesion, 03 medical and health sciences, Prostate cancer, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, mHSPC, SDG 3 - Good Health and Well-being, Dosimetry, Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15], Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14], Medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, Prospective cohort study, Index Lesion, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Prostatic Neoplasms, General Medicine, Prostate-Specific Antigen, medicine.disease, Hormones, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], Toxicity, Original Article, Bone marrow, medicine.symptom, Radiopharmaceuticals, business
الوصف: Introduction While [177Lu]Lu-PSMA radioligand therapy is currently only applied in end-stage metastatic castrate-resistant prostate cancer (mCRPC) patients, also low-volume hormone-sensitive metastatic prostate cancer (mHSPC) patients can benefit from it. However, there are toxicity concerns related to the sink effect in low-volume disease. This prospective study aims to determine the kinetics of [177Lu]Lu-PSMA in mHSPC patients, analyzing the doses to organs at risk (salivary glands, kidneys, liver, and bone marrow) and tumor lesions Methods Ten mHSPC patients underwent two cycles of [177Lu]Lu-PSMA therapy. Three-bed position SPECT/CT was performed at 5 time points after each therapy. Organ dosimetry and lesion dosimetry were performed using commercial software and a manual approach, respectively. Correlation between absorbed index lesion dose and treatment response (PSA drop of > 50% at the end of the study) was calculated and given as Spearman’s r and p-values. Results Kinetics of [177Lu]Lu-PSMA in mHSPC patients are comparable to those in mCRPC patients. Lesion absorbed dose was high (3.25 ± 3.19 Gy/GBq) compared to organ absorbed dose (salivary glands: 0.39 ± 0.17 Gy/GBq, kidneys: 0.49 ± 0.11 Gy/GBq, liver: 0.09 ± 0.01 Gy/GBq, bone marrow: 0.017 ± 0.008 Gy/GBq). A statistically significant correlation was found between treatment response and absorbed index lesion dose (p = 0.047). Conclusions We successfully performed small lesion dosimetry and showed that the tumor sink effect in mHSPC patients is of less concern than was expected. Tumor-to-organ ratio of absorbed dose was high and tumor uptake correlates with PSA response. Additional treatment cycles are legitimate in terms of organ toxicity and could lead to better tumor response.
وصف الملف: application/pdf
تدمد: 1619-7070
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::51f2ba65d5e6054957e9b82b1376f081
https://repository.ubn.ru.nl/handle/2066/248282
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....51f2ba65d5e6054957e9b82b1376f081
قاعدة البيانات: OpenAIRE
الوصف
تدمد:16197070