Outcomes of metastasis-directed therapy of bone oligometastatic prostate cancer

Radiation Oncology

Harun Ilhan¹  Minglun Li²  Rieke von Bestenbostel²  Run Shi²  Nina-Sophie Schmidt-Hegemann²  Christian Trapp²  Paul Rogowski²  Claus Belka³  Ute Ganswindt⁴  Alexander Kretschmer⁵  Christian Stief⁵ 

[1] Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany;Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany;Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany;German Cancer Consortium (DKTK), Munich, Germany;Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria;Department of Urology, University Hospital, LMU Munich, Munich, Germany;

关键词: Prostate cancer;    Oligometastases;    Bone metastases;    Radiotherapy;    SBRT;    Metastasis-directed therapy;   

DOI  :  10.1186/s13014-021-01849-8

来源: Springer

【 摘 要 】

BackgroundThe aim of this work was to investigate the outcome of metastasis-directed radiotherapy (MDT) in prostate cancer patients with bone metastases following current ESTRO/EORTC subclassifications for oligometastatic disease.MethodsClinical data of 80 consecutive oligometastatic patients with 115 bone lesions receiving MDT between 2011 and 2019 were retrospectively evaluated. Hormone-sensitive (77.5%) and castrate-resistant (22.5%) patients were included. MDT was delivered with conventional fractionated or stereotactic body radiotherapy (SBRT) techniques. Kaplan–Meier method, log rank test, as well as Cox regression were used to calculate local control (LC) and biochemical and clinical progression-free survival (bPFS/cPFS).ResultsAt the time of MDT 31% of patients had de-novo synchronous oligometastatic disease, 46% had de-novo metachronous oligorecurrence after primary treatment and 23% had either de-novo oligoprogressive disease, repeat oligometastatic disease or induced oligometastatic disease. The median BED3 was 93.3 Gy (range 75.8–95.3 Gy). Concomitant ADT was administered in 69% of patients. After a median follow-up of 23 months the median bPFS and cPFS were 16.5 and 21.5 months, respectively. The 2-year LC rate was 98.3%. In multivariate analysis, age ≤ 70 (HR = 2.60, 95% CI 1.20–5.62, p = 0.015) and concomitant ADT (HR = 0.26, 95% CI 0.12–0.58, p = 0.001) significantly correlated with cPFS. Category of oligometastatic disease and hormone-sensitivity were predictive for cPFS in univariate analysis. Of 45 patients with biochemical relapse, nineteen patients (42.2%) had repeat oligometastatic disease. Fourteen patients (31%) underwent a second course of MDT. No patients experienced grade ≥ 3 toxicities.ConclusionsMDT is safe and offers high local control rates in bone oligometastases of prostate cancer. At 2 years after treatment, more than 2 out of 5 patients are progression-free.Trial registration Retrospectively registered.

【 授权许可】

CC BY