Stereotactic Radiotherapy for oligoprogressive CRPC.

[pjoshea13]

New Italian study [2].

"Eighty-six patients for a total of 117 lesions were treated with SBRT. The median follow-up was 30.7 months (range 4-91 months). The median new metastasis-free survival after SBRT was 12.3 months (95% CI 5.5-19.1 months). One- and two-year distant progression-free survival was 52.3% and 33.7%, respectively. Twenty-six out of 86 patients underwent a second course of SBRT due to further oligoprogressive disease: This resulted in a median systemic treatment-free survival of 21.8 months (95% CI 17.8-25.8 months). One-year systemic treatment-free survival was 72.1%."

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/308...

World J Urol. 2019 Mar 11. doi: 10.1007/s00345-019-02717-7. [Epub ahead of print]

Metastasis-directed stereotactic radiotherapy for oligoprogressive castration-resistant prostate cancer: a multicenter study.

Triggiani L1, Mazzola R2, Magrini SM1, Ingrosso G3, Borghetti P1, Trippa F4, Lancia A3, Detti B5, Francolini G5, Matrone F6, Bortolus R6, Fanetti G6, Maranzano E4, Pasqualetti F7, Paiar F7, Bonù ML1, Magli A8, Bruni A9, Mazzeo E9, Franzese C10, Scorsetti M10,11, Alongi F1,12, Jereczek-Fossa BA13,14, Ost P15, Buglione M1.

Author information

1

Radiation Oncology Department, University and Spedali Civili Hospital, Brescia, Italy.

2

Radiation Oncology Department, IRCCS, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy. [e-mail].

3

Department of Radiation Oncology, Policlinico Tor Vergata, University of Rome, Rome, Italy.

4

Radiation Oncology Centre, "S. Maria" Hospital, Terni, Italy.

5

Department of Radiation Oncology, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.

6

Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Aviano, PN, Italy.

7

Department of Radiation Oncology, University Hospital S. Chiara, Pisa, Italy.

8

Department of Radiation Oncology, University Hospital of Udine, ASUIUD, Udine, Italy.

9

Radiotherapy Unit, Oncology and Hematology Department, University Hospital of Modena, Modena, Italy.

10

IRCCS, Radiotherapy and Radiosurgery Department, Humanitas University Hospital, Milan-Rozzano, Italy.

11

Department of Biomedical Sciences, Humanitas University, Milan-Rozzano, Italy.

12

Radiation Oncology Department, IRCCS, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy.

13

Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.

14

Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy.

15

Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium.

Abstract

PURPOSE:

Herein, we report the clinical outcomes of a multicenter study evaluating the role of SBRT in a cohort of patients affected by oligoprogressive castration-resistant prostate cancer (CRPC).

MATERIALS AND METHODS:

This is a retrospective multicenter observational study including eleven centers. Inclusion criteria of the current study were: (a) Karnofsky performance status > 80, (b) histologically proven diagnosis of PC, (c) 1-5 oligoprogressive metastases, defined as progressive disease at bone or nodes levels (detected by means of choline PET/CT or CT plus bone scan) during ADT, (d) serum testosterone level under 50 ng/ml during ADT, (e) controlled primary tumor, (f) patients treated with SBRT with a dose of at least 5 Gy per fraction to a biologically effective dose (BED) of at least 80 Gy using an alpha-to-beta ratio of 3 Gy, (g) at least 6 months of follow-up post-SBRT.

RESULTS:

Eighty-six patients for a total of 117 lesions were treated with SBRT. The median follow-up was 30.7 months (range 4-91 months). The median new metastasis-free survival after SBRT was 12.3 months (95% CI 5.5-19.1 months). One- and two-year distant progression-free survival was 52.3% and 33.7%, respectively. Twenty-six out of 86 patients underwent a second course of SBRT due to further oligoprogressive disease: This resulted in a median systemic treatment-free survival of 21.8 months (95% CI 17.8-25.8 months). One-year systemic treatment-free survival was 72.1%.

CONCLUSION:

SBRT appears to be a promising approach in oligoprogressive castration-resistant prostate cancer. Further investigations are warranted.

KEYWORDS:

CRPC; Metastasis-directed therapy; Prostate cancer; Radiotherapy; SBRT

PMID: 30859273 DOI: 10.1007/s00345-019-02717-7

[NPfisherman]

Another fabulous oligo article... Thank you for posting, Patrick...

All the best,

Fish

[cesanon]

Am I missing something, or is there no control group here?

[cigafred]

I think the reference "World J Urol. 2019 Mar 11. doi: 10.1007/s00345-019-02717-7. [Epub ahead of print]" is for the similar Belgian study? The Pubmed link is not working, at least at the moment, but again I think it is for the Belgian study you also posted?

[cigafred in reply to cigafred]

Pubmed link now working. I was wrong, it is for the correct study. But I think the reference I quote above is the Belgian study. In any case I have what I need, and thanks very much Patrick.