45583503 PET/CT | Cancer Diagnostic - Prostate cancer therapy

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What is radioisotope therapy

The treatment with radioactive isotope  is an effective treatment method for metastatic prostate cancer. Often radioisotope therapy is used when treatment options with other approved methods have been exhausted, have proven ineffective, or the patient cannot tolerate them. The aim of radioisotope therapy is to reduce tumor volume, the rate of metastatic dissemination and other symptoms of the disease.

What is the effect of  radioisotope therapy?

The amount of prostate-specific membrane antigen (PSMA) increases significantly in prostate cancer cells, and if the prostate cancer has spread to other parts of the body, then PSMA expression will be detectable there, too. Radioisotope in combination with a special peptide binds to PSMA receptors located on cancer cells, and radioactive isotope destroys these cancer cells.

Radioisotope therapy procedure details

  • Radioisotope therapy is administered through a peripheral venous catheter.
  • One treatment session lasts 6-8 hours, during which time the patient must remain in the clinic.
  • The total treatment consists of 2-6 cycles with 6-8 week intervals.
  • Close and prolonged contact with people should be avoided 24 hours after the injection (it is advisable to refrain from flying/traveling/attending events).

Frequently observed adverse reactions:

The majority of patients treated with  radioisotopes usually do not experience serious adverse reactions. The most frequent are:

  • Dry mouth and/or eyes (up to 30% of patients).
  • Nausea and vomiting (up to 10% of patients).
  • Haematopoietic suppression in patients with metastatic bone lesions.

Patient selection criteria:

Inclusion criteria:

  1. Patients with metastatic castration-resistant prostate cancer (mCRPC) for whom the available approved (alternative) treatment methods have been exhausted or are not suitable.
  2. Patients who have previously undergone the following examinations:
    • PET/CT with PSMA, not earlier than 2 months before radioisotope therapy, which confirms the increased PSMA expression.
    • A complete blood count with serum biochemistry, including ASAT, ALT, creatinine, PSA level in the serum, not earlier than 10 days prior to  radioisotope therapy.
  3. Information about the stage of the disease before the treatment, information about the treatments applied, previous examinations, histological results.
  4. The patient agrees to the use of anonymized data for research purposes.
  5. The decision on the appropriateness of  radioisotope therapy for each specific patient is made by a consilium of specialist doctors.

Exclusion criteria:

  1. General health status according to the Karnofsky > 70 points, unless the aim of the therapy is to reduce symptoms of the disease.
  2. Severe dysfunction of the urinary system (obstruction, hydronephrosis).
  3. Advancing and uncontrolled illnesses, including liver and kidney diseases, and infections.
  4. Suppression of the bone marrow function:
    • leukocyte count < 2.5 x 109/L
    • thrombocyte count < 75 x 109/L

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