Application of 68Ga-PSMA PET/CT in the precision treatment of prostate cancer
10.3760/cma.j.cn112330-20210408-00016
- VernacularTitle:68Ga-PSMA PET/CT在前列腺癌全程化精准治疗中的应用
- Author:
Peng WU
1
;
Jianhua JIAO
;
Chunjuan TIAN
;
Shuaijun MA
;
Lichun WEI
;
Jing ZHANG
;
Jing REN
;
Daliang LIU
;
Fuli WANG
;
Weijun QIN
Author Information
1. 空军军医大学西京医院泌尿外科，西安 710032
- Keywords:
Prostate cancer;
Whole-process management;
Prostate specific membrane antigen;
Multidisciplinary diagnosis and treatment model
- From:
Chinese Journal of Urology
2021;42(Z1):63-66
- CountryChina
- Language:Chinese
-
Abstract:
We retrospectively analyzed the clinical characteristic of one patient with metastatic prostate cancer and the relative literatures were reviewed. A 40-year-old man was admitted and diagnosed as prostate cancer on March 20, 2018(T 4N 1M 1a) with prostate-specific antigen (PSA) at 47.99 ng/ml. The first 68Ga-PSMA PET/CT showed multiple nodular lesions in the bilateral peripheral bands of the prostate, multiple nodular lesions in the right apex, abnormal uptake of nuclides in multiple lymph nodes in the abdominal aortic wandering zone, the abdominal aortic bifurcation zone, and the bilateral iliac artery wandering zone at the level of the lumbar 2-5 vertebral body, and metastasis was considered. The patient was treated with six cycles of drug castration combined with antiandrogenic treatment and pre-operative system chemotherapy(docetaxel). Six months later, the PSA decreased to 0.225ng/ml. Robot-assisted laparoscopic prostatectomy and expanded pelvic lymph node dissection was performed. Postoperative total androgen blocking therapy was maintained, and PSA slowly increased. Ten months after operation, salvage radiotherapy for enlarged lymph nodes was performed in pelvic extension field, prostate tumor bed area and pelvic cavity. PSA remained stable for 7 months postradiotherapy, and then increased. The patient developed castration-resistant prostate cancer and was treated with triptorelin combined with abiraterone. PSA was decreased, and local radiotherapy was performed for new lymph node metastases in the neck. 68Ga-PSMA PET/CT could provide a decision-making basis for accurate clinical staging, therapeutic effect evaluation and distant metastatic lesions location with guiding value for the formulation of individualized treatment plans.
