TY - JOUR
T1 - Metastasis-directed Therapy in Treating Nodal Oligorecurrent Prostate Cancer: A Multi-institutional Analysis Comparing the Outcome and Toxicity of Stereotactic Body Radiotherapy and Elective Nodal Radiotherapy
AU - De Bleser, Elise
AU - Jereczek-Fossa, Barbara Alicja
AU - Pasquier, David
AU - Zilli, Thomas
AU - Van As, Nicholas
AU - Siva, Shankar
AU - Fodor, Andrei
AU - Dirix, Piet
AU - Gomez-Iturriaga, Alfonso
AU - Trippa, Fabio
AU - Detti, Beatrice
AU - Ingrosso, Gianluca
AU - Triggiani, Luca
AU - Bruni, Alessio
AU - Alongi, Filippo
AU - Reynders, Dries
AU - De Meerleer, Gert
AU - Surgo, Alessia
AU - Loukili, Kaoutar
AU - Miralbell, Raymond
AU - Silva, Pedro
AU - Chander, Sarat
AU - Di Muzio, Nadia Gisella
AU - Maranzano, Ernesto
AU - Francolini, Giulio
AU - Lancia, Andrea
AU - Tree, Alison
AU - Deantoni, Chiara Lucrezia
AU - Ponti, Elisabetta
AU - Marvaso, Giulia
AU - Goetghebeur, Els
AU - Ost, Piet
PY - 2019/12
Y1 - 2019/12
N2 - BACKGROUND: Stereotactic body radiotherapy (SBRT) and elective nodal radiotherapy (ENRT) are being investigated as metastasis-directed treatments in oligorecurrent prostate cancer (PC); however, comparative data are still lacking. OBJECTIVE: To compare outcome and toxicity between both treatments. Primary endpoint was metastasis-free survival, adjusted for selected variables (aMFS). DESIGN, SETTING, AND PARTICIPANTS: This was a multi-institutional, retrospective analysis of 506 (SBRT: 309, ENRT: 197) patients with hormone-sensitive nodal oligorecurrent PC (five or fewer lymph nodes (LNs; N1/M1a), treated between 2004 and 2017. Median follow-up was 36 mo (interquartile range 23-56). INTERVENTION: SBRT was defined as a minimum of 5 Gy per fraction to each lesion with a maximum of 10 fractions. ENRT was defined as a minimum dose of 45 Gy in up to 25 fractions to the elective nodes, with or without a simultaneous boost to the suspicious node(s). The choice of radiotherapy (RT) was at the discretion of the treating physician, with treatments being unbalanced over the centers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: In total, 506 patients from 15 different treatment centers were included. Primary treatment was radical prostatectomy, RT, or their combination. Nodal recurrences were detected by positron emission tomography/computer tomography (97%) or conventional imaging (3%). Descriptive statistics was used to summarize patient characteristics. RESULTS AND LIMITATIONS: ENRT was associated with fewer nodal recurrences compared with SBRT (p
AB - BACKGROUND: Stereotactic body radiotherapy (SBRT) and elective nodal radiotherapy (ENRT) are being investigated as metastasis-directed treatments in oligorecurrent prostate cancer (PC); however, comparative data are still lacking. OBJECTIVE: To compare outcome and toxicity between both treatments. Primary endpoint was metastasis-free survival, adjusted for selected variables (aMFS). DESIGN, SETTING, AND PARTICIPANTS: This was a multi-institutional, retrospective analysis of 506 (SBRT: 309, ENRT: 197) patients with hormone-sensitive nodal oligorecurrent PC (five or fewer lymph nodes (LNs; N1/M1a), treated between 2004 and 2017. Median follow-up was 36 mo (interquartile range 23-56). INTERVENTION: SBRT was defined as a minimum of 5 Gy per fraction to each lesion with a maximum of 10 fractions. ENRT was defined as a minimum dose of 45 Gy in up to 25 fractions to the elective nodes, with or without a simultaneous boost to the suspicious node(s). The choice of radiotherapy (RT) was at the discretion of the treating physician, with treatments being unbalanced over the centers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: In total, 506 patients from 15 different treatment centers were included. Primary treatment was radical prostatectomy, RT, or their combination. Nodal recurrences were detected by positron emission tomography/computer tomography (97%) or conventional imaging (3%). Descriptive statistics was used to summarize patient characteristics. RESULTS AND LIMITATIONS: ENRT was associated with fewer nodal recurrences compared with SBRT (p
KW - Elective nodal radiotherapy
KW - Metastasis-directed therapy
KW - Oligometastasis
KW - Oligorecurrence
KW - Prostatic neoplasms
KW - Radiotherapy
KW - Recurrence
KW - Stereotactic ablative body radiotherapy
KW - Stereotactic body radiotherapy
U2 - 10.1016/j.eururo.2019.07.009
DO - 10.1016/j.eururo.2019.07.009
M3 - Article
VL - 76
SP - 732
EP - 739
JO - European Urology
JF - European Urology
SN - 0302-2838
IS - 6
ER -