Background/Objectives:To investigate the efficacy and safety of treatment with [177Lu]Lu-PSMA-I&T Radioligand Therapy (PSMA-RLT) in older patients (≥80 years) vs. younger ones with metastatic castration-resistant prostate cancer (mCRPC).Methods:In this retrospective single-center analysis, 103 patients treated with PSMA-RLT between 2019 and 2024 were included. Overall survival (OS) and therapeutic response were assessed by PSA serum and based on PET/CT Imaging according to the RECIP 1.0 criteria, respectively. Toxicity was additionally assessed via laboratory (hemoglobin, cell counts, and serum creatinine). Adverse events (AEs) were detected according to CTCAE V.5.Results:Median OS did not differ significantly in patients ≥ 80 years vs. <80 years (13.7 vs. 16.1 months, respectively). PSA decline of ≥50% was achieved in 32% patients in total, comparably in both groups (29.4% vs. 34.8%). According to RECIP 1.0, the majority of patients with both ≥80 and <80 years demonstrated stable disease or partial responses in imaging (64% and 71%, post two cycles). Concerning toxicity, the most frequently observed AE was anemia, which occurred in both <80 and ≥80 subgroups (grade 3: 2.8% vs. 5.9%); however, no grade 4 anemia was recorded. Renal function remained stable throughout treatment, and no AE grade 3 or higher was observed. Overall, the safety profile was comparable between age groups.Conclusions:Treatment with PSMA-RLT can be both effective and well tolerated in patients with mCRPC aged 80 years and older.
背景/目的：本研究旨在比较[¹⁷⁷Lu]Lu-PSMA-I&T放射性配体疗法（PSMA-RLT）在80岁及以上与较年轻转移性去势抵抗性前列腺癌（mCRPC）患者中的疗效与安全性。 方法：本回顾性单中心分析纳入2019年至2024年间接受PSMA-RLT治疗的103例患者。总生存期（OS）通过PSA血清水平评估，治疗反应则基于PET/CT影像学结果，并依据RECIP 1.0标准进行判定。此外，通过实验室检查（血红蛋白、血细胞计数及血清肌酐）评估毒性反应，不良事件（AEs）依据CTCAE V.5标准进行记录。 结果：≥80岁与<80岁患者的中位OS无显著差异（分别为13.7个月 vs. 16.1个月）。总体有32%的患者达到PSA下降≥50%，两组间比例相近（29.4% vs. 34.8%）。根据RECIP 1.0标准，在完成两个周期治疗后，≥80岁和<80岁患者中多数表现为疾病稳定或部分缓解（分别为64%和71%）。在毒性方面，最常见的不良事件为贫血，两组均有发生（3级：2.8% vs. 5.9%），但未记录到4级贫血。肾功能在整个治疗期间保持稳定，未观察到3级或更高级别的不良事件。总体而言，不同年龄组的安全性特征相似。 结论：PSMA-RLT治疗对于80岁及以上的mCRPC患者具有良好疗效，且耐受性良好。
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