骨转移在晚期前列腺癌中非常常见，可以利用 PSMA-PET/CT 灵敏地检测到。因此，我们的目标是评估 PSMA-PET/CT 引导的转移定向外照射放射治疗 (MDT) 作为生化复发和寡转移性骨病变患者的治疗选择的适用性。我们回顾性检查了 32 名生化复发和寡转移的前列腺癌患者。 PSMA 阳性寡转移性疾病仅限于骨（n = 1-3）。总共 49 个骨病变接受了 MDT 治疗。所有患者均接受放射治疗后 PSMA-PET/CT 扫描。计算 SUVmax、每个病灶的 PSMA 阳性肿瘤体积和 PSA 的变化，以及 PET/CT 间隔和 SUVmax 反应之间的相关性。MDT 导致 46/49 (94%) 病灶的 SUVmax 降低。 SUVmax 的中位相对下降分别为 60.4%。根据 SUV 截止值为 4 的 PSMA 阳性病灶体积，在 PSMA-PET/ 上，46/49 (94%) 的病灶显示完全缓解，2 个 (4%) 部分缓解，1 个病灶 (2%) 稳定MDT 后 CT。大多数接受治疗的患者 (56.3%) 在 3 个月时表现出初始 PSA 下降，并在 MDT 后中位时间 3.6 个月后 PSA 最低点为 0.14 ng/ml。 MDT 后三个月的中位相对 PSA 变化为 3.9%。MDT 是前列腺癌骨寡转移的一种非常有效的治疗方式，并且可以使用（半）定量参数 SUVmax 和 PSMA 阳性病灶体积来评估 MDT 病灶反应确定了 SUV 的截止标准。© 2024。作者。

Bone metastases are very common in advanced prostate cancer and can sensitively be detected utilizing PSMA-PET/CT. Therefore, our goal was to evaluate the suitability of PSMA-PET/CT-guided metastasis-directed external beam radiotherapy (MDT) as treatment option for patients with biochemical recurrence and oligometastatic bone lesions.We retrospectively examined 32 prostate cancer patients with biochemical recurrence and PSMA-positive oligometastatic disease limited to the bone (n = 1-3). A total of 49 bone lesions were treated with MDT. All patients received a post-radiotherapy PSMA-PET/CT-Scan. Changes in SUVmax, PSMA-positive tumor volume per lesion and PSA, as well as the correlation between the PET/CT-interval and SUVmax response were calculated.MDT lead to a SUVmax decrease in 46/49 (94%) of the lesions. The median relative decline of SUVmax was 60.4%, respectively. Based on PSMA-positive lesion volume with a SUV cut-off of 4, 46/49 (94%) of lesions showed complete response, two (4%) partial response and one lesion (2%) was stable on PSMA-PET/CT after MDT. Most of the treated patients (56.3%) showed an initial PSA decline at three months and a PSA nadir of median 0.14 ng/ml after a median time of 3.6 months after MDT. The median relative PSA change at three months after MDT was 3.9%.MDT is a very effective treatment modality for prostate cancer bone oligometastases and lesion response to MDT can be assessed using the (semi-)quantitative parameters SUVmax and PSMA-positive lesion volume with established SUV cut-offs.© 2024. The Author(s).