<sup>177</sup>Lu-PSMA放射性配体治疗在转移性去势抵抗性前列腺癌的应用初探

武鹏; 张景良; 李宇; 张明如; 王喆; 汪静; 秦卫军

doi:10.13201/j.issn.1001-1420.2022.05.009

¹⁷⁷Lu-PSMA放射性配体治疗在转移性去势抵抗性前列腺癌的应用初探

- 1.
  空军军医大学西京医院泌尿外科(西安，710032)
- 2.
  空军军医大学西京医院核医学科

详细信息

通讯作者: 秦卫军，E-mail：qinwj@fmmu.edu.cn

中图分类号: R737.25

收稿日期: 2022-01-03

刊出日期: 2022-05-06

Application of ¹⁷⁷Lu PSMA radioligand in the treatment of metastatic castration-resistant prostate cancer

- 1.
  Department of Urology, Xijing Hospital, Air Force Military Medical University, Xi'an, 710032, China
- 2.
  Department of Nuclear Medicine, Xijing Hospital, Air Force Military Medical University

More Information

Corresponding author: QIN Weijun, E-mail: qinwj@fmmu.edu.cn

Received Date: 03 January 2022

Publish Date: 06 May 2022

摘要

摘要: 目的评估¹⁷⁷Lu-PSMA放射性配体治疗在转移性去势抵抗性前列腺癌的安全性及初步疗效。方法收集2017—2020年空军军医大学西京医院收治并接受¹⁷⁷Lu-PSMA放射性配体治疗的转移性去势抵抗性前列腺癌患者，对其中3例典型患者的临床资料进行回顾性分析。结果病例1确诊前列腺癌后，分别先后予以前列腺癌根治术、双侧睾丸切除术、放疗、转移灶切除+粒子植入术，PSA有效控制10余年后持续上升，⁶⁸Ga-PSMA PET/CT提示多发淋巴结及骨转移，行2个周期¹⁷⁷Lu-PSMA放射性配体治疗后，PSA由2092 ng/mL下降至920 ng/mL，治疗前后血红蛋白、白细胞、肝肾功无明显变化。病例2术前行⁶⁸Ga-PSMA PET/CT发现2处骨转移灶，新辅助内分泌治疗6个月后行前列腺癌根治术，术后PSA逐渐升高，影像学检查发现转移灶增加，行3个周期¹⁷⁷Lu-PSMA放射性配体治疗，复查⁶⁸Ga-PSMA PET/CT转移灶缩小，病灶活性明显降低。病例3为高危转移性前列腺癌，予以去势+新型内分泌治疗后，PSA控制不佳，加用多西他赛化疗，2年后复查发现肝转移，遂行1个周期¹⁷⁷Lu-PSMA放射性配体治疗，PSA水平明显下降。结论 ¹⁷⁷Lu-PSMA放射性配体治疗是针对转移性去势抵抗性前列腺癌的新型治疗模式，具有较好的临床前景，安全性良好。
- 前列腺特异性膜抗原 /
- 转移性去势抵抗性前列腺癌 /
- ¹⁷⁷镥 /
- 放射性配体治疗
Abstract: Objective To evaluate the efficacy and safety of ¹⁷⁷Lu PSMA radioligand in the treatment of metastatic castration-resistant prostate cancer.Methods The patients with metastatic castration-resistant prostate cancer treated with ¹⁷⁷Lu PSMA radioactive ligand in Xijing Hospital, Air Force Military Medical University from 2017 to 2020 were collected, and the clinical data of 3 typical patients were analyzed retrospectively.Results Case 1 received radical prostatectomy, bilateral orchiectomy, radiotherapy, metastasis resection+brachytherapy. PSA continued to rise after more than 10 years of effective control. The ⁶⁸Ga-PSMA PET/CT showed multiple lymph nodes and bone metastasis. After 2 cycles of ¹⁷⁷Lu-PSMA radioactive ligand treatment, PSA decreased from 2092 ng/mL to 920 ng/mL. There was no significant change in hemoglobin, leukocytes, liver or kidney function. In case 2, two bone metastases were found on ⁶⁸Ga-PSMA PET/CT before operation. Radical prostatectomy was performed after 6 months of neoadjuvant endocrine therapy. PSA gradually increased after operation. Imaging examination found that the metastases increased. Three cycles of ¹⁷⁷Lu-PSMA radioactive ligand treatment were performed. The ⁶⁸Ga-PSMA PET/CT metastases decreased and the activity of the lesions decreased significantly. Case 3 was high-risk metastatic prostate cancer. After castration + new endocrine therapy, PSA control was poor. Docetaxel chemotherapy was added. Liver metastasis was found after two years. One cycle of ¹⁷⁷Lu-PSMA radioactive ligand treatment was carried out, and the PSA level decreased significantly.Conclusion ¹⁷⁷Lu-PSMA radioligand therapy is a novel therapeutic model for metastatic castration-resistant prostate cancer, with high clinical promise and good safety.
- prostate-specific membrane antigen /
- metastatic castration-resistant prostate cancer /
- ¹⁷⁷lutetium /
- radioligand therapy

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图 1 ⁶⁸Ga-PSMA PET/CT显示

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图 2 ¹⁷⁷Lu-PSMA治疗前后⁶⁸Ga-PSMA PET/CT显像结果

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图 3 ¹⁷⁷Lu-PSMA RLT后24 h SPECT/CT显像结果

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