Vorster, MarizaWarwick, J.Lawal, Ismaheel OpeyemiDu Toit, P.Vangu, M.Nyakale, N.E.Steyn, R.Gutta, A.A.Hart, G.Mutambirwa, S.Ellmann, A.Sathekge, Mike Machaba2020-03-092020-03-092019-12Vorster, M., Warwick, J., Lawal, I.O. et al. 2019, 'South African guidelines for receptor radioligand therapy (RLT) with Lu-177-PSMA in prostate cancer', South African Journal of Surgery, vol. 57, no. 4, pp. 45-51.0038-2361 (print)2078-5151 (online)10.17159/2078-5151/2019/v57n4a3107http://hdl.handle.net/2263/73685BACKGROUND : Prostate cancer is an important cause of morbidity and mortality in South Africa, as it is in the rest of the world. In African men, however, prostate cancer tends to follow a more aggressive course when compared to their European counterparts. This is attributed to a plethora of diverse factors of which an underlying genetic component has been shown to be an important aspect. Such differences highlight the need for individualised therapy and for local guidelines. The aim of this guideline is to aid nuclear physicians and other clinicians who manage patients with prostate cancer in the correct identification and treatment of patients who are likely to benefit from receptor radioligand therapy. RECOMMENDATIONS : There are a multitude of treatment modalities available for the treatment of prostate cancer and these therapies may be required at various time points during the course of the disease in any individual patient. A multidisciplinary approach is crucial in deciding which therapy, or combination of therapies, would be most advantageous at particular time points. The multidisciplinary team should include a urologist, oncologist and nuclear medicine physician as a minimum, and should ideally also involve a palliative/pain specialist, a dietician and a psychologist. CONCLUSION : Treatment with 177Lu-PSMA has emerged as a promising systemic modality, which involves the delivery of targeted radiation therapy in the form of β-particles to sites of tumour tissue. Therapy is provided on an outpatient basis, is well tolerated with relatively few side effects and has a positive effect on overall survival and quality of life. At present, it is used mostly in the setting of advanced, castrate-resistant cancer. Patients are selected (amongst other criteria) based on the prior PSMA-based SPECT/PET/CT imaging (99mTc-,68Ga- or 18F-PSMA), which should demonstrate sufficient receptor expression in order to consider PSMA-based targeted radionuclide therapy. Such imaging of an intended target prior to its therapeutic targeting is known as a theranostic approach.en© 2019 Health and Medical Publishing Group. This article is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0) .177Lu-PSMAMetastatic castrate-resistant prostate cancerTheranosticsSouth Africa (SA)Prostate cancerMortalityMorbidityReceptor radioligand therapy (RLT)Article