Akademik Veri Yönetim Sistemi
European Association of Nuclear Medicine Congress, Vienna, Avusturya, 9 - 13 Eylül 2023, ss.151-152
Aim/Introduction: We aimed to investigate the efect of
extended Lu177-PSMA radioligand treatment (PSMA-RLT) on
renal function in patients with metastatic castration-resistant
prostate cancer. Materials and Methods: The cohort included
54 patients who received ≥4 cycles of PSMA-RLT. All patients
underwent post-treatment whole body and SPECT/CT images
at 4th, 24th and 96th hours after each cycles. Renal dosimetry for each cycles were calculated using the OLINDA/EXM 1.1 program.
Pre and post-treatment blood creatinine values were measured
and nephrotoxicity was graded according to CTCAE v4.0. Risk
factors for nephrotoxicity included pre-existing renal disease,
comorbidities and history of chemotherapy and radiotherapy
were recorded. Results: Median of PSMA-RLT cycles was 6 and
the number of cycles of PSMA-RLT were 4 in 13 patients, 5-8 in
38 patients and 9-10 in 3 patients. The median age was 71 (range,
54-89) years and the median baseline creatinine value was 0.83
mg/dL (range,0.5-2,19). Median of cumulative renal dose (cRD)
of 4 cycles in 54 patients was 12.71 Gy (IQR: 4,83). After 4 cycles,
maximum cRD was 20,64 Gy. In 38 patients who received 5-8
cycles, median of cRD was 21.8 Gy (IQR:7,15) and maximum cRD
was 35,1 Gy. In 3 patients who received 9-10 cycles, median of
cRD was 39.1 Gy (IQR:7,5) and maximum cRD was 44,27 Gy.
According to CTCAE v4.0, none of the 54 patients received grade
2 or more than 2 nephrotoxicity. After PSMA-RLT, 13 patients
(24%) had grade 1 nephropathy. Of those, 5 patients had grade
1 nephropathy at baseline. In 8 patients, who developed grade 1
nephropathy, median and maximum cRD were 23,25 and 44,27
Gy, respectively. 7 patients (13%) received cRD more than 28
Gy without any severe nephrotoxicity. Conclusion: Our results
showed that extended PSMA-RLT is safe for renal function.
PSMA-RLT could be continued in patients who responded
treatment with personalized dosimetric evaluation without
any severe nephrotoxicity. Maximum cumulative renal doses of
PSMA-RLT should be determined in prospective, multi-centric studies.