奧攝敏檢查對於攝護腺癌治療的影響以及後續成效

許哲元、林益聖、許兆畬、歐宴泉、童敏哲

童綜合醫療社團法人童綜合醫院 外科部 泌尿科

The Impact of F18-Fluciclovine Positron Emission Tomography on Prostate Cancer Managements and Outcomes After Changing Managements

Jhe Yuan Hsu, Yi Sheng Lin, Chao Yu Hsu, Yen Chuan Ou, Min Che Tung

Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan

Purpose: F18-Fluciclovine positron emission tomography (PET) is an imaging facility to detect suspected progressive prostate cancer. We want to discuss the impact of F18-Fluciclovine PET on prostate cancer managements and outcomes after changing managements.

Materials and Methods: The study consists of patients with prostate cancer, accepting the F18-Fluciclovine PET after conventional imaging within six months. Patients was separated into two groups. One revealed suspected malignant lesion on F18-Fluciclovine PET but no findings on conventional imaging. The other showed the same findings. We further collected the categories of demographics, including age, initial clinical stage, Gleason score, initial prostate specific antigen (PSA), initial treatment, time from initial treatment to F18-Fluciclovine PET, PSA doubling time (PSADT), further management after F18-Fluciclovine PET, and PSA after changing managements. We analyzed the PSA results of those who accepted changing managements.

Results: Thirty-one men were chosen as our research participants after excluding incomplete treatment or losing follow-ups. There is no statistically significant difference between the two groups in all demographics aforementioned. Compared to conventional imaging, 16 men showed positive findings on F18-Fluciclovine PET, and further changed managements. After comparing the PSA at diagnosis of prostate cancer and further treatment after F18-Fluciclovine PET, we found that two of them revealed higher PSA, one of them with PSA decreasing to 66%, and one of them with PSA decreasing to 11%. The rest of them (75%) showed more than 90% decreasing PSA.

Conclusion: As to our clinical experience, elevated PSA is indicated for F18-Fluciclovine PET. Moreover, most patients accept further treatments can lead to significant benefits of PSA response.