Quantitative PSMA-PET parameters in localized prostate cancer: prognostic and potential predictive value.

IF 3.3 2区医学 Q2 ONCOLOGY

Radiation Oncology Pub Date : 2024-07-29 DOI:10.1186/s13014-024-02483-w

Stephanie Bela Andela, Holger Amthauer, Christian Furth, Julian M Rogasch, Marcus Beck, Felix Mehrhof, Pirus Ghadjar, Jörg van den Hoff, Tobias Klatte, Rana Tahbaz, Daniel Zips, Frank Hofheinz, Sebastian Zschaeck

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引用次数: 0

Abstract

Background: PSMA-PET is increasingly used for staging prostate cancer (PCA) patients. However, it is not clear if quantitative imaging parameters of positron emission tomography (PET) have an impact on disease progression and are thus important for the prognosis of localized PCA.

Methods: This is a monocenter retrospective analysis of 86 consecutive patients with localized intermediate or high-risk PCA and PSMA-PET before treatment The quantitative PET parameters maximum standardized uptake value (SUV_max), tumor asphericity (ASP), PSMA tumor volume (PSMA-TV), and PSMA total lesion uptake (PSMA-TLU = PSMA-TV × SUV_mean) were assessed for their prognostic significance in patients with radiotherapy or surgery. Cox regression analyses were performed for biochemical recurrence-free survival, overall survival (OS), local control, and loco-regional control (LRC).

Results: 67% of patients had high-risk disease, 51 patients were treated with radiotherapy, and 35 with surgery. Analysis of metric PET parameters in the whole cohort revealed a significant association of PSMA-TV (p = 0.003), PSMA-TLU (p = 0.004), and ASP (p < 0.001) with OS. Upon binarization of PET parameters, several other parameters showed a significant association with clinical outcome. When analyzing high-risk patients according to the primary treatment approach, a previously published cut-off for SUV_max (8.6) showed a significant association with LRC in surgically treated (p = 0.048), but not in primary irradiated (p = 0.34) patients. In addition, PSMA-TLU (p = 0.016) seemed to be a very promising biomarker to stratify surgical patients.

Conclusion: Our data confirm one previous publication on the prognostic impact of SUV_max in surgically treated patients with high-risk PCA. Our exploratory analysis indicates that PSMA-TLU might be even better suited. The missing association with primary irradiated patients needs prospective validation with a larger sample size to conclude a predictive potential. Trial registration Due to the retrospective nature of this research, no registration was carried out.

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局部前列腺癌的 PSMA-PET 定量参数：预后和潜在预测价值。

背景：PSMA-PET越来越多地被用于前列腺癌（PCA）患者的分期。然而，尚不清楚正电子发射断层扫描（PET）的定量成像参数是否对疾病进展有影响，因而对局部 PCA 的预后是否重要：方法：这是一项单中心回顾性分析，研究对象为连续86例局部中危或高危PCA患者，治疗前进行了PSMA-PET检查。评估了PET定量参数最大标准化摄取值（SUVmax）、肿瘤非球面度（ASP）、PSMA肿瘤体积（PSMA-TV）和PSMA总病灶摄取量（PSMA-TLU = PSMA-TV × SUVmean）对放疗或手术患者的预后意义。对无生化复发生存率、总生存率（OS）、局部控制率和局部区域控制率（LRC）进行了Cox回归分析：67%的患者患有高危疾病，51名患者接受了放疗，35名患者接受了手术治疗。对整个队列的PET指标进行分析后发现，PSMA-TV（p = 0.003）、PSMA-TLU（p = 0.004）和ASP（p max (8.6)）与手术治疗患者的LRC有显著相关性（p = 0.048），但与原发性放疗患者的LRC无显著相关性（p = 0.34）。此外，PSMA-TLU（p = 0.016）似乎是对手术患者进行分层的一个非常有前景的生物标志物：我们的数据证实了之前发表的一篇关于 SUVmax 对接受手术治疗的高危 PCA 患者预后影响的文章。我们的探索性分析表明，PSMA-TLU 可能更适合。与原发性照射患者的关联缺失需要更大样本量的前瞻性验证，才能得出预测潜力的结论。试验注册由于该研究具有回顾性，因此没有进行注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiation Oncology ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

6.50

自引率

2.80%

发文量

181

审稿时长

3-6 weeks

期刊介绍： Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.

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