Repeated stereotactic body radiotherapy for oligometastatic prostate cancer recurrence

Radiation Oncology

Piet Ost⁵  Gaethan Maes⁵  Arne Hautekiet⁵  Wouter Huysse³  Filip De Vos¹  Tom Claeys²  Valérie Fonteyne⁵  Louke Delrue³  Bieke Lambert⁴  Gert De Meerleer⁵  Karel Decaestecker² 

[1] Department of Radiopharmacy, Ghent University, Harelbekestraat 32, Ghent, Belgium;Department of Urology, Ghent University Hospital, De Pintelaan 185, Ghent, Belgium;Department of Radiology, Ghent University Hospital, De Pintelaan 185, Ghent, Belgium;Department of Nuclear Medicine, Ghent University Hospital, De Pintelaan 185, Ghent, Belgium;Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, Ghent, Belgium

关键词: Stereotactic body radiotherapy;    Salvage therapy;    Recurrence;    Prostate cancer;    Oligometastases;   

Others  :  801254
DOI  :  10.1186/1748-717X-9-135

 received in 2014-04-15, accepted in 2014-05-29,  发布年份 2014

【 摘 要 】

Purpose

To assess the outcome of prostate cancer (PCa) patients diagnosed with oligometastatic disease at recurrence and treated with stereotactic body radiotherapy (SBRT).

Methods

Non-castrate patients with up to 3 synchronous metastases (bone and/or lymph nodes) diagnosed on positron emission tomography - computed tomography, following biochemical recurrence after local curative treatment, were treated with (repeated) SBRT to a dose of 50 Gy in 10 fractions or 30 Gy in 3 fractions. Androgen deprivation therapy-free survival (ADT-FS) defined as the time interval between the first day of SBRT and the initiation of ADT was the primary endpoint. ADT was initiated if more than 3 metastases were detected during follow-up even when patients were still asymptomatic. Secondary endpoints were local control, progression free survival (PFS) and toxicity. Toxicity was scored using the Common Terminology Criteria for Adverse Events.

Results

With a median follow-up from time of SBRT of 2 years, we treated 50 patients with 70 metastatic lesions with a local control rate of 100%. The primary involved metastatic sites were lymph nodes (54%), bone (44%), and viscera (2%). The median PFS was 19 mo (95% CI: 13–25 mo) with 75% of recurring patients having ≤3 metastases. A 2^nd and 3^rd course of SBRT was delivered in 19 and 6 patients respectively. This results in a median ADT-FS of 25 months (20–30 mo). On univariate analysis, only a short PSA doubling time was a significant predictor for both PFS (HR: 0.90, 95% CI: 0.82 – 0.99) and ADT-FS (HR: 0.83; 95% CI: 0.71 – 0.97). Ten patients (20%) developed toxicity following treatment, which was classified as grade I in 7 and grade II in 3 patients.

Conclusion

Repeated SBRT for oligometastatic prostate cancer postpones palliative androgen deprivation therapy with 2 years without grade III toxicity.

【 授权许可】

   
2014 Decaestecker et al.; licensee BioMed Central Ltd.

【 图 表 】

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