Abstract
This study analyzed 99Tcm-MDP bone scans and investigated factors influencing early-stage castration resistance in prostate cancer (CRPC) patients with bone metastasis. We retrospectively analyzed clinical data from 92 patients with bone metastatic prostate cancer treated with maximal androgen blockade. Patients were imaged with 99Tcm-MDP bone scan to detect metastases, and prostate specific antigen (PSA) values were measured regularly. Before treatment, 464 total bone metastases were detected in the 92 patients, with pelvic bone metastases accounting for about 30.6% of the total. After combined androgen blockade treatment, median CRPC occurrence time was 23 months. A longer time to reach the lowest PSA value was an independent predictor of early-onset CRPC (occurrence <1 year after treatment). Our findings suggest that 99Tcm-MDP bone scans are useful for diagnosing prostate cancer bone metastasis and grading. Patients with Gleason scores>8, higher PSA values after treatment, and shorter times to reach the lowest PSA value had poorer responses to combined androgen blockade treatment.
Highlights
Prostate cancer incidence differs depending on geographical location and patient ethnicity
The results showed that the optimal cutoff value of the lowest prostate specific antigen (PSA) values and the time to reach the minimal PSA value for predicting castration resistance in prostate cancer (CRPC) were 0.2 ng/mL and 9 months, respectively
Patients were grouped according to clinical indicators, and chi-square test results showed that patients with Gleason scores (8–10vs. 6–7) had the lowest PSA values after combined androgen blockade therapy, and the time to reach the minimal PSA value was associated with CRPC development after treatment (Table 2)
Summary
Prostate cancer incidence differs depending on geographical location and patient ethnicity. In Europe, the United States, and other developed nations, prostate cancer is the most common malignancy in males [1]. Prostate cancer is the third most common malignancy of the male urinary tract and reproductive system in China, seriously affecting quality of life in elderly men. More than 90% of prostate cancer patients will eventually have bone metastases. Diagnosis of prostate cancer with or without bone metastases, and accurate assessment of bone metastasis locations and quantities are very important for therapeutic decisionmaking. Diagnosis of prostate cancer with or without bone metastases, and accurate assessment of bone metastasis locations and quantities are very important for therapeutic decisionmaking. 99Tcm-MDP is a noninvasive, highly sensitive radiotracer commonly used to screen for malignant tumors with or without bone metastases. 99Tcm-MDP is frequently used to diagnose prostate cancer patient bone metastases and to evaluate therapeutic efficacies [2]
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