Repeated stereotactic body radiotherapy for oligometastatic prostate cancer recurrence
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Open Access
- 12 June 2014
- journal article
- Published by Springer Science and Business Media LLC in Radiation Oncology
- Vol. 9 (1), 135
- https://doi.org/10.1186/1748-717x-9-135
Abstract
Purpose: To assess the outcome of prostate cancer (PCa) patients diagnosed with oligometastatic disease at recurrence and treated with stereotactic body radiotherapy (SBRT). Methods: Non-castrate patients with up to 3 synchronous metastases (bone and/or lymph nodes) diagnosed on positron emission tomography - computed tomography, following biochemical recurrence after local curative treatment, were treated with (repeated) SBRT to a dose of 50 Gy in 10 fractions or 30 Gy in 3 fractions. Androgen deprivation therapy-free survival (ADT-FS) defined as the time interval between the first day of SBRT and the initiation of ADT was the primary endpoint. ADT was initiated if more than 3 metastases were detected during follow-up even when patients were still asymptomatic. Secondary endpoints were local control, progression free survival (PFS) and toxicity. Toxicity was scored using the Common Terminology Criteria for Adverse Events. Results: With a median follow-up from time of SBRT of 2 years, we treated 50 patients with 70 metastatic lesions with a local control rate of 100%. The primary involved metastatic sites were lymph nodes (54%), bone (44%), and viscera (2%). The median PFS was 19 mo (95% CI: 13-25 mo) with 75% of recurring patients having <= 3 metastases. A 2nd and 3rd course of SBRT was delivered in 19 and 6 patients respectively. This results in a median ADT-FS of 25 months (20-30 mo). On univariate analysis, only a short PSA doubling time was a significant predictor for both PFS (HR: 0.90, 95% CI: 0.82 - 0.99) and ADT-FS (HR: 0.83; 95% CI: 0.71 - 0.97). Ten patients (20%) developed toxicity following treatment, which was classified as grade I in 7 and grade II in 3 patients. Conclusion: Repeated SBRT for oligometastatic prostate cancer postpones palliative androgen deprivation therapy with 2 years without grade III toxicityKeywords
This publication has 31 references indexed in Scilit:
- 18F-Fluoroethylcholine PET/CT Identifies Lymph Node Metastasis in Patients with Prostate-Specific Antigen Failure After Radical Prostatectomy but Underestimates Its ExtentEuropean Urology, 2013
- Stereotactic body radiation therapy in the treatment of oligometastatic prostate cancerFrontiers in Oncology, 2013
- Salvage Stereotactic Body Radiotherapy for Patients With Limited Prostate Cancer Metastases: Deferring Androgen Deprivation TherapyClinical Genitourinary Cancer, 2012
- ESUR prostate MR guidelines 2012European Radiology, 2012
- Progress in Gene Therapy for Prostate CancerFrontiers in Oncology, 2012
- Randomized study evaluating testosterone recovery using short-versuslong-acting luteinizing hormone releasing hormone agonistsCanadian Urological Association Journal, 2011
- Robotic Image-Guided Stereotactic Radiotherapy, for Isolated Recurrent Primary, Lymph Node or Metastatic Prostate CancerInternational Journal of Radiation Oncology*Biology*Physics, 2011
- Prostate Cancer: PET with 18F-FDG, 18F- or 11C-Acetate, and 18F- or 11C-CholineJournal of Nuclear Medicine, 2010
- The Natural History of Noncastrate Metastatic Prostate Cancer after Radical ProstatectomyEuropean Urology, 2006
- CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatmentSeminars in Radiation Oncology, 2003