Effect of body composition parameters, including sarcopenia, myosteatosis, and adipose tissue, on overall survival of patients with mCRPC receiving 177 Lu-PSMA PRRT.

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Nuclear Medicine Communications Pub Date : 2025-07-01 Epub Date: 2025-05-01 DOI:10.1097/MNM.0000000000001985
İhsan Kaplan, Halil Kömek, Canan Can, Fulya Kaya İpek, Ferat Kepenek, Hüseyin Karaoğlan, Ayhan Şenol, Fatih Güzel, Veysi Şenses, Ridvan Kiliç, Ömer Yeprem, Mehmet Serdar Yildirim, Bilgin Bahadir Başgöz, Yunus Güzel
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引用次数: 0

Abstract

Purpose: This study aimed to examine the role of computed tomography (CT)-derived myosteatosis, sarcopenia, and other body composition parameters on overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) scheduled to receive lutetium (Lu)-177 treatment.

Material and method: Patients with mCRPC who underwent 68 Ga-prostate-specific membrane antigen (PSMA) PET/CT imaging before [ 177 Lu]Lu-PSMA-617 treatment and received at least two cycles of Lu-177 PSMA treatment between March 2017 and March 2023 were retrospectively reviewed in this study. Body composition including psoas muscle, skeletal muscle, subcutaneous adipose tissue, and visceral adipose tissue were evaluated at the third lumbar spine vertebra on CT axial sections.

Results: Median age of the 76 patients enrolled in this study was 75 years (59-91 years), and the median Gleason score was 8 (6-10). All patients received two to six (median 4) cycles of 7.4 GBq Lu-177 PSMA treatment at 6-8 week intervals. Upon univariant Cox regression analysis, subcutaneous adipose tissue index, right psoas myosteatosis, left psoas myosteatosis, and skeletal muscle index were determined to be prognostic factors for OS ( P  = 0.03, P  = 0.02, P  < 0.001, and P  = 0.04, respectively). However, the left psoas myosteatosis value was an independent prognostic factor for OS as determined by multivariant Cox regression analysis ( P  < 0.001).

Conclusion: Sarcopenia and myosteatosis before treatment were associated with shorter survival in mCRPC patients who were scheduled for Lu-177 PSMA treatment. Patients with left psoas myosteatosis value ≤26.85 HU had shorter OS, and we showed that OS is an independent prognostic factor.

体成分参数(包括肌肉减少症、肌骨增生症和脂肪组织)对接受177Lu-PSMA PRRT的mCRPC患者总生存率的影响
目的:本研究旨在探讨转移性去势抵抗性前列腺癌(mCRPC)患者计划接受镥(Lu)-177治疗时,计算机断层扫描(CT)衍生的肌骨化症、肌肉减少症和其他身体成分参数对总生存率(OS)的作用。材料和方法:本研究回顾性回顾了2017年3月至2023年3月期间接受[177Lu]Lu-PSMA-617治疗前接受68ga -前列腺特异性膜抗原(PSMA) PET/CT成像并接受至少两个周期Lu-177 PSMA治疗的mCRPC患者。在第三腰椎的CT轴向切片上评估身体组成,包括腰肌、骨骼肌、皮下脂肪组织和内脏脂肪组织。结果:本研究纳入的76例患者中位年龄为75岁(59-91岁),中位Gleason评分为8分(6-10分)。所有患者接受2 - 6个(中位数4)周期的7.4 GBq Lu-177 PSMA治疗,间隔6-8周。通过单变量Cox回归分析,皮下脂肪组织指数、右侧腰肌骨化病、左侧腰肌骨化病和骨骼肌指数被确定为OS的预后因素(P = 0.03, P = 0.02, P)。结论:在计划接受Lu-177 PSMA治疗的mCRPC患者中,治疗前肌肉减少和骨化病与较短的生存期相关。左腰肌骨化值≤26.85 HU的患者OS较短,我们发现OS是一个独立的预后因素。
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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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