Stereotactic body radiotherapy in oligometastatic prostate cancer patients with isolated lymph nodes involvement: a two-institution experience
- 848 Downloads
Stereotactic body radiotherapy (SBRT) is emerging as a treatment option in oligometastatic cancer patients. This retrospective study aimed to analyze local control, biochemical progression-free survival (b-PFS), and toxicity in patients affected by isolated prostate cancer lymph node metastases. Finally, we evaluated androgen deprivation therapy-free survival (ADT-FS).
Forty patients with 47 isolated lymph nodes of recurrent prostate cancer were treated with SBRT. Mostly, two different fractionation schemes were used: 5 × 7 Gy in 23 (48.9 %) lesions and 5 × 8 Gy in 13 (27.7 %) lesions. Response to treatment was assessed with periodical PSA evaluation. Toxicity was registered according to RTOG/EORTC criteria.
With a mean follow-up of 30.18 months, local control was achieved in 98 % of the cases, with a median b-PFS of 24 months. We obtained a 2-year b-PFS of 44 % with 40 % of the patients ADT-free at last follow-up (mean value 26.18 months; range 3.96–59.46), whereas 12.5 % had a mean ADT-FS of 13.58 months (range 2.06–37.13). Late toxicity was observed in one (2.5 %) patient who manifested a grade 3 gastrointestinal toxicity 11.76 months after the end of SBRT.
Our study demonstrates that SBRT is safe, effective, and minimally invasive in the eradication of limited nodal metastases, yielding an important delay in prescribing ADT.
KeywordsProstate cancer Oligometastasis Stereotactic body radiotherapy Local control Androgen deprivation therapy-free survival
Gianluca Ingrosso was involved in data collection and management and wrote the manuscript. Fabio Trippa and Elisabetta Ponti were involved in data collection and management and edited the manuscript. Ernesto Maranzano and Riccardo Santoni edited the manuscript. Alessandra Carosi was involved in data management and data analysis and wrote the manuscript. Fabio Arcidiacono and Lorena Draghini were involved in data collection and management. Luana Di Murro and Andrea Lancia wrote the manuscript.
Compliance with ethical standards
In all patients, written informed consent was obtained.
- 2.Schweizer MT, Zhou XC, Wang H, Yang T, Shaukat F, Partin AW, Eisenberg MA, Antonarakis ES (2013) Metastasis-free survival is associated with overall survival in men with PSA-recurrent prostate cancer treated with deferred androgen deprivation therapy. Ann Oncol 24:2881–2886CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J (2009) New response criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45(2):228–247CrossRefPubMedGoogle Scholar
- 10.Berkovic P, De Meerleer G, Delrue L, Lambert B, Fonteyne V, Lumen N, Decaestecker K, Villeirs G, Vuye P, Ost P (2013) Salvage stereotactic body radiotherapy for patients with limited prostate cancer metastases: deferring androgen deprivation therapy. Clin Genitourin Cancer 11(1):27–32CrossRefPubMedGoogle Scholar
- 13.Picchio M, Berardi G, Fodor A, Busnardo E, Crivellaro C, Giovacchini G, Fiorino C, Kirienko M, Incerti E, Messa C, Gianolli L, Di Muzio N (2014) (11)C-Choline PET/CT as a guide to radiation treatment planning of lymph-node relapses in prostate cancer patients. Eur J Nucl Med Mol Imaging 41(7):1270–1279PubMedGoogle Scholar
- 15.Nuyttens JJ, Prevost JB, Van der Voort van Zijp NC, Hoogeman M, Levendag PC (2007) Curative stereotactic robotic radiotherapy treatment for extracranial, extrapulmonary, extrahepatic, and extraspinal tumors: technique, early results, and toxicity. Technol Cancer Res Treat 6(6):605–610CrossRefPubMedGoogle Scholar