TY - JOUR
T1 - „PSMA-radioguided surgery“ beim lokal begrenzten Prostatakarzinomrezidiv
T2 - Aktueller Stand und zukünftige Entwicklungen
AU - Rauscher, I.
AU - Eiber, M.
AU - Jilg, C. A.
AU - Gschwend, J. E.
AU - Maurer, T.
N1 - Publisher Copyright:
© 2016, Springer Medizin Verlag Berlin.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Recently, PSMA-radioguided surgery (PSMA-RGS) was introduced for targeted resection of localized prostate cancer recurrence. Prerequisite for preoperative patient selection and localization of tumor recurrence is a positive 68Ga-HBED-CC PSMA positron emission tomography (PET) scan with preferably only singular soft tissue or lymph node recurrence. After injection of In-PSMA I&T or Tc-PSMA-I&S single photon emission computer tomography (SPECT)/computer tomography (CT) examination is performed in every patient to verify radiotracer uptake in tumor lesions. In a preliminary study, 111In-PSMA I&T SPECT/CT could detect about half of the 68Ga-HBED-CC PSMA PET-positive lesions, while nearly all PET-positive lesions could be detected using PSMA-RGS and also five additional lesions compared to 68Ga-HBED-CC-PSMA PET. Follow-up data from 55 patients show a PSA reduction >50% and >90% in 44 (80%) and 29 (53%) patients, respectively. In 34 (62%) patients, a PSA drop to <0.2 ng/ml was observed. In all, 15 (27%) patients received further PC-specific treatment; the remaining 40 (73%) patients did not undergo further treatment. In 33% of patients, surgery-related complications were noted; however, most were regarded as minor. Thus, PSMA-RGS seems to be of high value in patients with localized prostate cancer recurrence with exact localization and resection of metastatic tissue. However, patient selection based on 68Ga-PSMA PET imaging and clinical parameters is crucial to obtain satisfactory oncological results.
AB - Recently, PSMA-radioguided surgery (PSMA-RGS) was introduced for targeted resection of localized prostate cancer recurrence. Prerequisite for preoperative patient selection and localization of tumor recurrence is a positive 68Ga-HBED-CC PSMA positron emission tomography (PET) scan with preferably only singular soft tissue or lymph node recurrence. After injection of In-PSMA I&T or Tc-PSMA-I&S single photon emission computer tomography (SPECT)/computer tomography (CT) examination is performed in every patient to verify radiotracer uptake in tumor lesions. In a preliminary study, 111In-PSMA I&T SPECT/CT could detect about half of the 68Ga-HBED-CC PSMA PET-positive lesions, while nearly all PET-positive lesions could be detected using PSMA-RGS and also five additional lesions compared to 68Ga-HBED-CC-PSMA PET. Follow-up data from 55 patients show a PSA reduction >50% and >90% in 44 (80%) and 29 (53%) patients, respectively. In 34 (62%) patients, a PSA drop to <0.2 ng/ml was observed. In all, 15 (27%) patients received further PC-specific treatment; the remaining 40 (73%) patients did not undergo further treatment. In 33% of patients, surgery-related complications were noted; however, most were regarded as minor. Thus, PSMA-RGS seems to be of high value in patients with localized prostate cancer recurrence with exact localization and resection of metastatic tissue. However, patient selection based on 68Ga-PSMA PET imaging and clinical parameters is crucial to obtain satisfactory oncological results.
KW - Gamma probe measurements
KW - Membrane antigen, prostate specific
KW - Positron emission tomography
KW - Salvage surgery
KW - Tumor recurrence
UR - http://www.scopus.com/inward/record.url?scp=84996931921&partnerID=8YFLogxK
U2 - 10.1007/s00120-016-0275-2
DO - 10.1007/s00120-016-0275-2
M3 - Artikel
C2 - 27885455
AN - SCOPUS:84996931921
SN - 0340-2592
VL - 56
SP - 18
EP - 23
JO - Urologe - Ausgabe A
JF - Urologe - Ausgabe A
IS - 1
ER -
