RESUMO
To assess the predictive and prognostic aim of interim and end-treatment 18F-fluorocholine PET/CT (FCH-PET/CT) and 99mTc-methilen diphosphonate bone scintigraphy (BS) in patients with castration-resistant prostate cancer and bone metastases (CRPC-BM) treated with Radium 223 dichloride (223Ra). Prospective and multicentre ChoPET-Rad study including 82 patients with CRPC-BM. Baseline, after 3 (interim) and 6 doses (end-treatment) BS and FCH PET/CT were performed in patients who meet the study criteria. Clinical variables, imaging and clinical progression were obtained and their association with progression free survival (PFS), and overall survival (OS) was studied. Agreement between BS and FCH PET/CT response was assessed using Kappa (K) analysis. Median of PFS and OS was 3 and 16 months, respectively. Agreement between interim BS and FCH PET/CT was weak (K: 0.28; p = 0.004). No agreement was observed between end-treatment diagnostic studies. Interim and end-treatment FCH PET/CT were related to PFS (p = 0.011 and p < 0.001, respectively). Therapeutic failure and interim BS and FCH PET/CT showed association with OS (p < 0.001, p = 0.037 and p = 0.008, respectively). Interim and end-treatment FCH PET/CT were good predictors of biochemical progression in patients treated with 223Ra. Therapeutic failure and progression in interim BS or FCH PET/CT were adverse factors for OS.
Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Colina/análogos & derivados , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Neoplasias da Próstata/diagnóstico por imagem , Rádio (Elemento)/química , Idoso , Neoplasias Ósseas/secundário , Colina/química , Progressão da Doença , Intervalo Livre de Doença , Humanos , Masculino , Pessoa de Meia-Idade , Medicina Molecular , Análise Multivariada , Modelos de Riscos Proporcionais , Estudos Prospectivos , Radioisótopos/química , Reprodutibilidade dos Testes , Resultado do TratamentoRESUMO
Cardiac metastases are more frequent than primaryheart neoplasias. Nearly any malignant tumourmay metastasize to the heart, but the most commonare carcinomas rather than sarcomas. We report thecase of a patient who presented with heart metastasis6 years after resection of an uterine leiomyosarcoma.The patient died thirty months after surgicalresection without evidence of cardiac recurrence.Although cardiac metastases from uterine leiomyosarcomaare exceptional, they should be suspectedin the presence of suggestive symptoms, since theycan be associated with long survival after surgicaltreatment
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