Bone flare after initiation of novel hormonal therapy in patients with metastatic hormone-sensitive prostate cancer:A case report  

作　　者：Ke-Hao Li Yuan-Cheng Du Dong-Yu Yang Xin-Yuan Yu Xue-Ping Zhang Yong-Xiang Li Liang Qiao 

机构地区：[1]Department of Clinic,Weifang Medical University,Weifang 261000,Shandong Province,China [2]Department of Urology,Weifang People's Hospital,Weifang 261000,Shandong Province,China

出　　处：《World Journal of Clinical Cases》2022年第15期4985-4990,共6页世界临床病例杂志

摘　　要：BACKGROUND The 2020 European Association of Urology prostate cancer guidelines recommend androgen deprivation therapy(ADT)in combination with apalutamide and enzalutamide,a new generation of androgen receptor antagonists,as first-line therapy.A decrease in prostate-specific antigen(PSA)levels may occur in the early stages of novel hormonal therapy;however,radionuclide bone imaging may suggest disease progression.During follow-up,PSA,radionuclide bone imaging,and prostate-specific membrane antigen(PSMA)positron emission tomography–computed tomography(PET-CT)are needed for systematic evaluation.CASE SUMMARY We admitted a 56-year-old male patient with metastatic hormone-sensitive prostate cancer.Initial radionuclide bone imaging,magnetic resonance imaging(MRI),and PSMA PET-CT showed prostate cancer with multiple bone metastases.Ultrasound-guided needle biopsy of the prostate revealed a poorly differentiated adenocarcinoma of the prostate with a Gleason score:5+4=9.The final diagnosis was a prostate adenocarcinoma(T4N1M1).ADT with novel hormonal therapy(goseraline sustained-release implant 3.6 mg monthly and apalutamide 240 mg daily)was commenced.Three months later,radionuclide bone imaging and MRI revealed advanced bone metastasis.However,PSMA PET-CT examination showed a significant reduction in PSMA aggregation on the bone,indicating improved bone metastases.Considering that progressive decrease in the presenting lumbar pain,treatment strategies were considered to be effective.CONCLUSION ADT using novel hormonal therapy is effective for treating patients with prostate adenocarcinoma.Careful evaluation must precede treatment plan changes.

关 键 词：Bone flare Novel hormonal therapy Metastatic hormone-sensitive prostate cancer Apalutamide Case report 

分 类 号：R737.25[医药卫生—肿瘤]