Dawn of Theranostics in Myanmar (Dream, Reality, and Constraint)
Prostate cancer is third common malignancy in men of old age (average 65 years) in Myanmar. Currently, serum PSA and bone scan are the markers of choice. Because of the evidence-based, promising success of 68Ga-PSMA PET-CT and 177Lu-PSMA theranostics in prostate cancer worldwide, 99mTc-PSMA SPECT-CT imaging and 177Lu-PSMA therapy has launched as a stepping-stone of theranostics in Myanmar with the available facilities. Twelve cases of prostate cancer patients were imaged with 600 MBq of 99mTc-PSMA I+S SPECT-CT. Four metastatic castration resistant prostate cancer (MCRPC) patients with abnormal result were treated with 177Lu-PSMA. The protocol consists of 6–8 GBq of 177Lu-PSMA, three successive doses at interval of 4–6 weeks. Post-therapy SPECT-CT imaging was done. All treated patients were improved by free of bone pain, and fall/rise in serum PSA level. Two patients with extensive skeletal metastases succumbed to complications. The results are well documented and present at the multidisciplinary conferences for clinical awareness. Theranostics in prostate cancer with available facilities is an additional boon to our health care professionals to upgrade cancer management in Myanmar. This paper provides the technology with cost effectiveness and benefit to prostate cancer patients of Myanmar.
KeywordsTheranostics SPECT-CT PET-CT PSMA Lutetium-177 Prostate cancer
The author would like to express kind appreciation to Dr. Tin Maung Thein, Dr. Thiri Kyi Phyu, Mr. Win Maung (Physicist), and all the staffs of PERFECT MMITC who are actively involved in this pilot study. I convey my sincere thanks to Mr. Kyaw Min Thet who makes photoshop editing of figures in this paper.
Compliance with Ethical Standards
Conflict of Interest
Kyin Myint, Tin Maung Thein, Thiri Kyi Pyhu, and Win Maung declare no conflict of interest.
All procedures performed in this study were in accordance with the ethical standards of national research committee.
Informed consent was obtained from individual patient included in this study according to the protocol approved by the ethical committee and kept confidential.