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Utility of Gallium-68 PSMA PET/CT Scan for Staging and Treatment of Prostate Cancer in Contemporary Era: Study from Tertiary Care Cancer Centre in a Developing Country

Date

24 Nov 2018

Session

Poster display - Cocktail

Presenters

Alok Gupta

Citation

Annals of Oncology (2018) 29 (suppl_9): ix67-ix73. 10.1093/annonc/mdy434

Authors

A. Gupta, S.M. Hussain, P. Ahluwalia, G. Gautam, A. Punnakal, H. Chaturvedi, A. Rajput, J. Bal, P. Dougall

Author affiliations

  • Medical Oncology, Max Institute of Cancer Care, 110024 - New Delhi/IN
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Resources

Background

Conventional imaging modalities including bone scan and CT scan have limited sensitivity and specificity compared to 68Ga-PSMA PET/CT scan in detection of metastatic prostate cancer. We analyzed the utility of 68Ga-PSMA PET/CT scan in staging and treatment decision making of prostate cancer at our Institute.

Methods

We retrospectively collected data of 330 prostate cancer patients treated between January 2015 and December 2017 at our institute. Patients with intermediate/high risk localized disease and regional lymph node positive disease on MRI, and those with suspected metastatic disease clinically underwent 68Ga-PSMA PET/CT scan. Overall, 168 patients who underwent baseline 68Ga-PSMA PET/CT scan were included in this study.

Results

Median age was 67 years (range 30-88) and median PSA was 30 ng/ml (range 1-4000). Gleason score was <7, 7 and >7 in 5, 56 and 93 patients, respectively. Radiological assessment by 68Ga-PSMA PET/CT scan revealed T2, T3 and T4 lesion in 19, 98 and 51 patients, respectively. Regional lymph nodes were involved in 99 patients while non-regional lymph nodes were involved in 38 patients. Bone metastasis was present in 53 patients and visceral metastasis was present in 18 patients. 108 patients with localized/loco-regional disease underwent treatment with curative intent while 60 patients with metastatic disease underwent treatment with palliative intent. Overall, 88 patients underwent robotic radical prostatectomy, 20 underwent radical radiation therapy while 60 were treated with Androgen Deprivation Therapy (ADT alone -27 patients, ADT with docetaxel - 22 patients or ADT with abiraterone – 11 patients).Table: 230P

Clinico-radiological characteristics and treatment received

CharacteristicNumber =168 (%)
Median Age (years) (Range)67 (30-88)
Median PSA (ng/ml) (Range)30 (1-4000)
Gleason score
65 (2.9)
756 (33)
852 (31)
938 (23)
103 (2)
unknown14 (8)
Ga 68-PSMA PET/CT Findings
Tumour size T219 (11)
T389 (53)
T435 (21)
Regional lymph nodes99 (59)
Non-regional lymph nodes38 (23)
Bone metastasis53 (32)
Visceral metastasis18 (11)
Treatment Intent - Curative108 (64)
Radical Prostatectomy88 (52)
Radical Radiotherapy20 (12)
Treatment intent - palliative60 (36)
ADT alone27 (16)
ADT + docetaxel22 (13)
ADT + abiraterone11 (7)

Conclusions

Within the limitations of a retrospective study we conclude that 68Ga-PSMA PET/CT scan is a useful radiological test for staging of prostate cance. As experience with this modality grows, increasingly it is being employed in treatment decision making.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Max Institute of Cancer Care.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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