Characteristics of the included articles.

BackgroundCurrent studies have shown inconsistent results regarding the impact of baseline alkaline phosphatase (ALP) levels on the prognosis of metastatic castration-resistant prostate cancer (mCRPC) patients who undergo 177Lu-prostate-specific membrane antigen (PSMA) radioligand therapy (PRLT). Therefore, a comprehensive meta-analysis is needed to clarify the implications.MethodsThis study was carried out in full compliance with the PRISMA protocol 2020, and a comprehensive search was conducted through PubMed, Web of Science, and Embase for published literature up to April 1st, 2024. Random-effects models were used to assess the correlation between baseline ALP and overall survival (OS) or progression-free survival (PFS) of mCRPC patients treated with 177Lu-PRLT, with a significance level set at α = 0.05.ResultsA total of 12 articles were included in this study. The pooled effect estimates for baseline ALP and OS were 1.134 (95% CI: 1.035–1.245), I2 = 78.7%, P CI: 1.232–3.718), I2 = 93.3%, P ConclusionThis meta-analysis demonstrates a significant association between elevated baseline ALP levels in mCRPC patients prior to 177Lu-PRLT treatment and inferior OS and PFS. Timely monitoring of baseline ALP levels can provide valuable insights for clinical decision-making and patient counseling.背景 现有研究针对基线碱性磷酸酶（alkaline phosphatase, ALP）水平对接受177Lu-前列腺特异性膜抗原（prostate-specific membrane antigen, PSMA）放射配体治疗（PRLT）的转移性去势抵抗性前列腺癌（metastatic castration-resistant prostate cancer, mCRPC）患者预后的影响所得结果存在不一致性，因此亟需开展全面的荟萃分析以明确其临床意义。 方法 本研究严格遵循PRISMA 2020声明执行，通过PubMed、Web of Science及Embase数据库检索截至2024年4月1日的已发表相关文献。采用随机效应模型评估接受177Lu-PRLT治疗的mCRPC患者基线ALP水平与总生存期（overall survival, OS）、无进展生存期（progression-free survival, PFS）的相关性，检验水准设定为α=0.05。 结果 本研究共纳入12篇文献。基线ALP与OS的合并效应估计值为1.134（95%置信区间：1.035~1.245），I²=78.7%，[原文此处存在内容缺失]；基线ALP与PFS的合并效应估计值相关数据为（95%置信区间：1.232~3.718），I²=93.3%，[原文此处P值相关结果缺失]。 结论 本荟萃分析证实，接受177Lu-PRLT治疗前的mCRPC患者基线ALP水平升高与较差的OS及PFS存在显著关联。及时监测基线ALP水平可为临床决策制定及患者咨询提供极具价值的参考依据。