The efficacy of Stereotactic body radiation therapy and the impact of systemic treatments in oligometastatic patients from prostate cancer

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Abstract

Background: Diagnoses of oligometastatic prostate cancer (PC) increased in the recent years thanks to the advancement in imaging and more effective systemic therapies. Here we evaluate the efficacy of Stereotactic Body Radiation Therapy (SBRT) in oligorecurrent and oligoprogressive PC. Methods: We included patients with a maximum of five metastases diagnosed in a maximum of two target organs. Concomitant treatment with hormonal therapies or chemotherapies was allowed. End points of the present study were the outcome in terms of Local control of treated metastases (LC), out-field progression free survival, overall progression free survival (PFS), and overall survival. Results: We included in the analysis 64 patients treated on 90 metastases. Fifty (78.1%) patients were treated on lymph nodes, 2 (3.1%) patients simultaneously on lymph node and bone while 10 (15.7%) patients on bone only. Lung metastases were treated in 2 (3.1%) patients. Thirty-seven (57.81%) were without androgen deprivation therapy when treated with SBRT. Median follow-up was 15.2 months. Rates of LC at 6-, 12-, and 18- months were 94%, 88%, and 84%, respectively. Oligoprogressive patients compared to oligorecurrent (HR 9.10, P = 0.049) and prolongation of time from diagnosis of metastases to SBRT (HR 1.03, P = 0.047) were associated with worse LC. Median PFS was 6.6 months (range 1.1-42.4). Castration resistant patients experienced worse PFS compared to castration sensitive group (HR 2.12, P = 0.021). Conclusions: Stereotactic body radiation therapy seems to be an effective treatment for metastases from PC. Prospective trials are necessary to better define selection of patients and to evaluate combination of SBRT and new systemic drugs in castration resistant patients.

Original languageEnglish
Pages (from-to)4379-4386
Number of pages8
JournalCancer Medicine
Volume7
Issue number9
DOIs
Publication statusPublished - Sep 1 2018

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Prostatic Neoplasms
Radiotherapy
Neoplasm Metastasis
Disease-Free Survival
Castration
Therapeutics
Lymph Nodes
Bone and Bones
Patient Selection
Androgens
Outcome Assessment (Health Care)
Drug Therapy
Lung
Survival
Pharmaceutical Preparations

Keywords

  • hormonal therapy
  • oligometastases
  • prostate cancer
  • stereotactic body radiation therapy
  • systemic treatment

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

@article{324e01db5bc6438aa4c198a2eab29a1a,
title = "The efficacy of Stereotactic body radiation therapy and the impact of systemic treatments in oligometastatic patients from prostate cancer",
abstract = "Background: Diagnoses of oligometastatic prostate cancer (PC) increased in the recent years thanks to the advancement in imaging and more effective systemic therapies. Here we evaluate the efficacy of Stereotactic Body Radiation Therapy (SBRT) in oligorecurrent and oligoprogressive PC. Methods: We included patients with a maximum of five metastases diagnosed in a maximum of two target organs. Concomitant treatment with hormonal therapies or chemotherapies was allowed. End points of the present study were the outcome in terms of Local control of treated metastases (LC), out-field progression free survival, overall progression free survival (PFS), and overall survival. Results: We included in the analysis 64 patients treated on 90 metastases. Fifty (78.1{\%}) patients were treated on lymph nodes, 2 (3.1{\%}) patients simultaneously on lymph node and bone while 10 (15.7{\%}) patients on bone only. Lung metastases were treated in 2 (3.1{\%}) patients. Thirty-seven (57.81{\%}) were without androgen deprivation therapy when treated with SBRT. Median follow-up was 15.2 months. Rates of LC at 6-, 12-, and 18- months were 94{\%}, 88{\%}, and 84{\%}, respectively. Oligoprogressive patients compared to oligorecurrent (HR 9.10, P = 0.049) and prolongation of time from diagnosis of metastases to SBRT (HR 1.03, P = 0.047) were associated with worse LC. Median PFS was 6.6 months (range 1.1-42.4). Castration resistant patients experienced worse PFS compared to castration sensitive group (HR 2.12, P = 0.021). Conclusions: Stereotactic body radiation therapy seems to be an effective treatment for metastases from PC. Prospective trials are necessary to better define selection of patients and to evaluate combination of SBRT and new systemic drugs in castration resistant patients.",
keywords = "hormonal therapy, oligometastases, prostate cancer, stereotactic body radiation therapy, systemic treatment",
author = "Ciro Franzese and Zucali, {Paolo Andrea} and {Di Brina}, Lucia and Giuseppe D'Agostino and Pierina Navarria and Davide Franceschini and Armando Santoro and Marta Scorsetti",
year = "2018",
month = "9",
day = "1",
doi = "10.1002/cam4.1707",
language = "English",
volume = "7",
pages = "4379--4386",
journal = "Cancer Medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",
number = "9",

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TY - JOUR

T1 - The efficacy of Stereotactic body radiation therapy and the impact of systemic treatments in oligometastatic patients from prostate cancer

AU - Franzese, Ciro

AU - Zucali, Paolo Andrea

AU - Di Brina, Lucia

AU - D'Agostino, Giuseppe

AU - Navarria, Pierina

AU - Franceschini, Davide

AU - Santoro, Armando

AU - Scorsetti, Marta

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: Diagnoses of oligometastatic prostate cancer (PC) increased in the recent years thanks to the advancement in imaging and more effective systemic therapies. Here we evaluate the efficacy of Stereotactic Body Radiation Therapy (SBRT) in oligorecurrent and oligoprogressive PC. Methods: We included patients with a maximum of five metastases diagnosed in a maximum of two target organs. Concomitant treatment with hormonal therapies or chemotherapies was allowed. End points of the present study were the outcome in terms of Local control of treated metastases (LC), out-field progression free survival, overall progression free survival (PFS), and overall survival. Results: We included in the analysis 64 patients treated on 90 metastases. Fifty (78.1%) patients were treated on lymph nodes, 2 (3.1%) patients simultaneously on lymph node and bone while 10 (15.7%) patients on bone only. Lung metastases were treated in 2 (3.1%) patients. Thirty-seven (57.81%) were without androgen deprivation therapy when treated with SBRT. Median follow-up was 15.2 months. Rates of LC at 6-, 12-, and 18- months were 94%, 88%, and 84%, respectively. Oligoprogressive patients compared to oligorecurrent (HR 9.10, P = 0.049) and prolongation of time from diagnosis of metastases to SBRT (HR 1.03, P = 0.047) were associated with worse LC. Median PFS was 6.6 months (range 1.1-42.4). Castration resistant patients experienced worse PFS compared to castration sensitive group (HR 2.12, P = 0.021). Conclusions: Stereotactic body radiation therapy seems to be an effective treatment for metastases from PC. Prospective trials are necessary to better define selection of patients and to evaluate combination of SBRT and new systemic drugs in castration resistant patients.

AB - Background: Diagnoses of oligometastatic prostate cancer (PC) increased in the recent years thanks to the advancement in imaging and more effective systemic therapies. Here we evaluate the efficacy of Stereotactic Body Radiation Therapy (SBRT) in oligorecurrent and oligoprogressive PC. Methods: We included patients with a maximum of five metastases diagnosed in a maximum of two target organs. Concomitant treatment with hormonal therapies or chemotherapies was allowed. End points of the present study were the outcome in terms of Local control of treated metastases (LC), out-field progression free survival, overall progression free survival (PFS), and overall survival. Results: We included in the analysis 64 patients treated on 90 metastases. Fifty (78.1%) patients were treated on lymph nodes, 2 (3.1%) patients simultaneously on lymph node and bone while 10 (15.7%) patients on bone only. Lung metastases were treated in 2 (3.1%) patients. Thirty-seven (57.81%) were without androgen deprivation therapy when treated with SBRT. Median follow-up was 15.2 months. Rates of LC at 6-, 12-, and 18- months were 94%, 88%, and 84%, respectively. Oligoprogressive patients compared to oligorecurrent (HR 9.10, P = 0.049) and prolongation of time from diagnosis of metastases to SBRT (HR 1.03, P = 0.047) were associated with worse LC. Median PFS was 6.6 months (range 1.1-42.4). Castration resistant patients experienced worse PFS compared to castration sensitive group (HR 2.12, P = 0.021). Conclusions: Stereotactic body radiation therapy seems to be an effective treatment for metastases from PC. Prospective trials are necessary to better define selection of patients and to evaluate combination of SBRT and new systemic drugs in castration resistant patients.

KW - hormonal therapy

KW - oligometastases

KW - prostate cancer

KW - stereotactic body radiation therapy

KW - systemic treatment

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