Stereotactic ablative radiotherapy for oligometastatic prostate cancer

Elena Gallizia, Eleonora Ferrara, Debora Beldì, Micol Zannetti, Gianfranco Loi, Pierfrancesco Franco, Alessandra Gennari, Marco Krengli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The present study assessed clinical outcomes of stereotactic body radiotherapy (SBRT) in oligometastatic prostate cancer patients. Materials and methods: Between 2017 and 2020, 37 lesions (12 osseous and 25 nodal targets) detected with conventional and/or functional imaging, were treated in 29 patients (pts), in different clinical settings: de novo oligometastatic (2 pts), oligorecurrent castration-sensitive (19 pts), castration-resistant (6 pts) prostate cancers and oligoprogressive disease during systemic therapy (2 pts). SBRT was delivered with volumetric modulated arc therapy up to a total dose of 21 Gy given in 3 fractions for bone and 30 Gy in 5 fractions for nodal metastases. A total of 34% of pts received hormonal therapy. We evaluated biochemical control [prostate serum antigen (PSA) increase < 10%)], progression free-survival (PFS) (time from SBRT to biochemical progression), local control (LC) (time from SBRT to in-field radiologic progression), hormone/systemic therapy-free survival, acute and late toxicities. Results: At 3 months, biochemical response was observed in 20/29 pts (69%). At a median follow-up of 17 months (range 6-33), 8/20 (40%) of the 3-month responders remained free from progression. Two-year PFS and LC were 37% and 70%, respectively. In-field progression occurred in 3/37 (8%) lesions. Hormone/systemic therapy was delayed by an average of 11.6 months (range 3–28). No significant difference in PFS based on the type of lesion or concomitant endocrine therapy was observed and no toxicity > grade 2 was reported. Conclusions: SBRT for oligometastatic prostate cancer offers a good biochemical/local control and tangible delay of hormone/ systemic therapy without major toxicities.

Original languageEnglish
Pages (from-to)778-786
Number of pages9
JournalReports of Practical Oncology and Radiotherapy
Volume27
Issue number5
DOIs
Publication statusPublished - 2022

Keywords

  • Bone metastases
  • Lymph node metastases
  • Oligometastasis
  • Prostate cancer
  • Stereotactic radiotherapy

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