Contributo da PET/CT com Fluorocolina-F18 na Radioterapia Externa do Carcinoma da Próstata
DOI:
https://doi.org/10.25748/arp.10626Resumo
Objetivo: A radioterapia é uma opção terapêutica no carcinoma da próstata. Pretendemos avaliar o contributo da PET/CT com Fluorocolina-F18(FCH-F18) na identificação dos doentes com indicação para essa estratégia terapêutica e o impacto no seu planeamento. Material e Métodos: Analisámos retrospetivamente 282 PET/CT com FCH-F18. Seleccionámos 187 doentes sem antecedentes de radioterapia prévia (41 estadiamentos iniciais/146 recidivas bioquímicas). Registámos os resultados da PET/CT com FCH-F18 (doença localizada com indicação para radioterapia versus doença à distância) e investigámos a opção terapêutica assumida em cada doente. No grupo que realizou radioterapia identificámos as situações em que a PET/CT com FCH-F18 otimizou o planeamento e anotámos os valores do PSA após radioterapia. Resultados: Apresentavam doença localizada 139 doentes (34 estadiamentos/105 recidivas). Destes, 54 realizaram radioterapia (8 estadiamentos/46 recidivas). A PET/CT com FCH-F18 contribuiu para a otimização de 22 (41%) planeamentos com intuito curativo ou de salvação, e, ainda, de 3 doentes para radioterapia paliativa. Os valores do PSA após radioterapia diminuiram significativamente sugerindo uma evolução favorável. Conclusão: A PET/CT com FCH-F18 foi útil na orientação terapêutica dos doentes com carcinoma da próstata, nomeadamente na seleção daqueles que tinham indicação para radioterapia e contribuiu para a optimização do seu planeamento numa percentagem significativa de casos.
Referências
Jereczek-Fossa BA, Rodari M, Bonora M, Fanti P, Fodor C, Pepe G, et al. [11C]choline PET/CT impacts treatment decision making in patients with prostate cancer referred for radiotherapy. Clin Genitourin Cancer. 2014;12(3):155-9.
Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, et al. EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 2014;65(1):124-37.
Picchio M, Mapelli P, Panebianco V, Castellucci P, Incerti E, Briganti A, et al. Imaging biomarkers in prostate cancer: role of PET/CT and MRI. Eur J Nucl Med Mol Imaging. 2015;42(4):644-55.
Abuzallouf S, Dayes I, Lukka H. Baseline staging of newly diagnosed prostate cancer: a summary of the literature. J Urol. 2014;171:2122-7.
Hricak H, Choyke P, Eberhardt S, Leibel S, Scardino P. Imaging prostate cancer: a multidisciplinary prespective. Radiology. 2007;243:28-53.
Kent C. Regulation of phosphatidylcholine biosynthesis. Prog Lipid Res. 1990;29(2):87-105.
Fox JJ, Schöder H, Larson SM. Molecular imaging of prostate cancer. Curr Opin Urol. 2012;22(4):320-7.
Ceci F, Castellucci P, Graziani T, Schiavina R, Brunocilla E, Mazzarotto R, et al. 11C-choline PET/CT detects the site of relapse in the majority of prostate cancer patients showing biochemical recurrence after EBRT. Eur J Nucl Med Mol Imaging. 2014;41(5):878-86.
Kelloff GJ, Choyke P, Coffey DS, Group PCIW. Challenges in clinical prostate cancer: role of imaging. AJR Am J Roentgenol. 2009;192(6):1455-70.
Kitajima K, Murphy RC, Nathan MA, Froemming AT, Hagen CE, Takahashi N, et al. Detection of recurrent prostate cancer after radical prostatectomy: comparison of 11C-choline PET/CT with pelvic multiparametric MR imaging with endorectal coil. J Nucl Med. 2014;55(2):223-32.
Brenot-Rossi I. [Focus: Prostate cancer and PET-choline]. Prog Urol. 2014;24(1):3-8.
Sharma S. Imaging and intervention in prostate cancer: Current perspectives and future trends. Indian J Radiol Imaging. 2014;24(2):139-48.
Lecouvet FE, Lhommel R, Pasoglou V, Larbi A, Jamar F, Tombal B. Novel imaging techniques reshape the landscape in high-risk prostate cancers. Curr Opin Urol. 2013;23(4):323-30.
Evangelista L, Guttilla A, Zattoni F, Muzzio PC, Zattoni F. Utility of choline positron emission tomography/computed tomography for lymph node involvement identification in intermediate-to high-risk prostate cancer: a systematic literature review and meta-analysis. Eur Urol. 2013;63:1040–1048.
López E, Lazo A, Gutiérrez A, Arregui G, Núñez I, Sacchetti A. Influence of (11)C-choline PET/CT on radiotherapy planning in prostate cancer. Rep Pract Oncol Radiother. 2015;20(2):104-12.
Castellucci P, Ceci F, Graziani T, Schiavina R, Brunocilla E, Mazzarotto R, et al. Early biochemical relapse after radical prostatectomy: which prostate cancer patients may benefit from a restaging 11C-Choline PET/CT scan before salvage radiation therapy? J Nucl Med. 2014;55(9):1424-9.
Picchio M, Giovannini E, Crivellaro C, Gianolli L, di Muzio N, Messa C. Clinical evidence on PET/CT for radiation therapy planning in prostate cancer. Radiother Oncol. 2010;96(3):347-50.
Souvatzoglou M, Krause BJ, Pürschel A, Thamm R, Schuster T, Buck AK, et al. Influence of (11)C-choline PET/CT on the treatment planning for salvage radiation therapy in patients with biochemical recurrence of prostate cancer. Radiother Oncol. 2011;99(2):193-200.
Picchio M, Briganti A, Fanti S, Heidenreich A, Krause BJ, Messa C, et al. The role of choline positron emission tomography/computed tomography in the management of patients with prostate-specific antigen progression after radical treatment of prostate cancer. Eur Urol. 2011;59(1):51-60.
Alongi F, Fersino S, Giaj Levra N, Mazzola R, Ricchetti F, Fiorentino A, et al. Impact of 18F-Choline PET/CT in the Decision-Making Strategy of Treatment Volumes in Definitive Prostate Cancer Volumetric Modulated Radiation Therapy. Clin Nucl Med. 2015.
Cimitan M, Bortolus R, Morassut S, et al. [18F]fluorocholine PET/CT imaging for the detection of recurrent cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med Mol Imaging. 2006;33:1387-98.
Schmid D, John H, Zweifel R, et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology. 2005;235:623-8.
Beheshti M, Imamovic L, Broinger G, et al. [18F]choline PET/CT in the preoperative staging of prostate cancer in patients with intermediate or high risk of extracapsular disease: a prospective study of 130 patients. Radiology. 2010;254:925-33.
Sharma P, Mukherjee A. Newer positron emission tomography radiopharmaceuticals for radiotherapy planning: an overview. Ann Transl Med. 2016;4(3):53.
Garcia JR, Jorcano S, Soler M, Linero D, Moragas M, Riera E, et al. 11C-holine PET/CT in the primary diagnosis of prostate cancer: impact on treatment planning. Q J Nucl Med Mol Imaging. 2014.
García JR, Cozar M, Soler M, Bassa P, Riera E, Ferrer J. Salvage radiotherapy in prostate cancer patients. Planning, treatment response and prognosis using (11)C-choline PET/CT. Rev Esp Med Nucl Imagen Mol. 2016.
Picchio M, Berardi G, Fodor A, Busnardo E, Crivellaro C, Giovacchini G, et al. (11)C-Choline PET/CT as a guide to radiation treatment planning of lymph-node relapses in prostate cancer patients. Eur J Nucl Med Mol Imaging. 2014;41(7):1270-9.
Würschmidt F, Petersen C, Wahl A, Dahle J, Kretschmer M. [18F]fluoroethylcholine-PET/CT imaging for radiation treatment planning of recurrent and primary prostate cancer with dose escalation to PET/CT-positive lymph nodes. Radiat Oncol. 2011;6:44.
Chang JH, Lim Joon D, Lee ST, Gong SJ, Anderson NJ, Scott AM, et al. Intensity modulated radiation therapy dose painting for localized prostate cancer using ¹¹C-choline positron emission tomography scans. Int J Radiat Oncol Biol Phys. 2012;83(5):e691-6.
Schwarzenböck SM, Kurth J, Gocke C, Kuhnt T, Hildebrandt G, Krause BJ. Role of choline PET/CT in guiding target volume delineation for irradiation of prostate cancer. Eur J Nucl Med Mol Imaging. 2013;40 Suppl 1:S28-35.
Vavassori V, Alongi F, D'agostino GA, Della Bosca E, Scorsetti M. Lymph-node relapsed prostate cancer management and PET-driven external beam radiotherapy: salvage or palliative treatment? Q J Nucl Med Mol Imaging. 2015;59(4):411-9.
Pasqualetti F, Panichi M, Sainato A, Matteucci F, Galli L, Cocuzza P, et al. [(18)F]Choline PET/CT and stereotactic body radiotherapy on treatment decision making of oligometastatic prostate cancer patients: preliminary results. Radiat Oncol. 2016;11(1):9.
Kuang Y, Wu L, Hirata E, Miyazaki K, Sato M, Kwee SA. Volumetric modulated arc therapy planning for primary prostate cancer with selective intraprostatic boost determined by 18F-choline PET/CT. Int J Radiat Oncol Biol Phys. 2015;91(5):1017-25.
De Jong IJ, De Haan TD, Wiegman EM, Van Den Bergh AC, Pruim J, Breeuwsma AJ. PET/CT and radiotherapy in prostate cancer. Q J Nucl Med Mol Imaging. 2010;54(5):543-52.
Chan J, Syndikus I, Mahmood S, Bell L, Vinjamuri S. Is choline PET useful for identifying intraprostatic tumour lesions? A literature review. Nucl Med Commun. 2015;36(9):871-80.
Kairemo K, Rasulova N, Kiljunen T, Partanen K, Kangasmäki A, Joensuu T. PET/CT Dose Planning for Volumetric Modulated Arc Radiation Therapy (VMAT) -Comparison with Conventional Approach in Advanced Prostate Cancer Patients. Curr Radiopharm. 2015;8(1):2-8.
Pinkawa M, Holy R, Piroth MD, Klotz J, Nussen S, Krohn T, et al. Intensity-modulated radiotherapy for prostate cancer implementing molecular imaging with 18F-choline PET-CT to define a simultaneous integrated boost. Strahlenther Onkol. 2010;186(11):600-6.
Dewes S, Schiller K, Sauter K, Eiber M, Maurer T, Schwaiger M, et al. Integration of (68)Ga-PSMA-PET imaging in planning of primary definitive radiotherapy in prostate cancer: a retrospective study. Radiat Oncol. 2016;11:73.
Xie W, Tan AE, Cheng C, Whatt AG. Occult Prostate Cancer Detected with 18F-Fluorocholine Positron Emission Tomography/Computed Tomography. World J Nucl Med. 2014;13(3):205-8.
Downloads
Publicado
Edição
Secção
Licença
Autor (es) (ou seu (s) empregador (es)) e ARP 2024. Reutilização permitida de acordo com CC BY-NC. Nenhuma reutilização comercial.
