Oligorecurrent prostate cancer limited to lymph nodes: getting our ducks in a row

Fodor, Andrei; Lancia, Andrea; Ceci, Francesco; Picchio, Maria; Høyer, Morten; Jereczek‐Fossa, Barbara Alicja; Ost, Piet; Castellucci, Paolo; Incerti, Elena; Muzio, N. Di; Ingrosso, Gianluca

doi:10.1007/s00345-018-2322-7

Cited by 18 publications

(7 citation statements)

References 43 publications

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“…In fact, in these subjects the risk of misdiagnosing disseminated micrometastatic disease as oligorecurrent PCa would be minimized. [ 56 ] However, an argument against this hypothesis is that these patients could be the ones with latent metastatic PCa, which was simply not detected in the past due to less sensitive tracer (given the low metabolic uptake of these lesions) and which have a very good prognosis even without any intervention. Furthermore, it could be hypothesized that even selected tumors with short PSA doubling time could be managed with MDT, given the possibility of repeating the latter until widespread metastatic diffusion.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic radiotherapy of nodal oligometastases from prostate cancer: a prisma-compliant systematic review

Zamagni

Bonetti

Buwenge

et al. 2022

Clin Exp Metastasis

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Androgen deprivation therapy (ADT) is the standard treatment of metastatic prostate cancer (PCa). However, metastases-directed therapies can delay the initiation or switch of systemic treatments and allow local control (LC) and prolonged progression-free survival (PFS), particularly in patients with lymph nodes (LN) oligometastases. We performed a systematic review on stereotactic body radiotherapy (SBRT) in this setting. Papers reporting LC and/or PFS were selected. Data on ADT-free survival, overall survival, and toxicity were also collected from the selected studies. Fifteen studies were eligible (414 patients), 14 of them were retrospective analyses. A high heterogeneity was observed in terms of patient selection and treatment. In one study SBRT was delivered as a single 20 Gy fraction, while in the others the median total dose ranged between 24 and 40 Gy delivered in 3–6 fractions. LC and PFS were reported in 15 and 12 papers, respectively. LC was reported as a crude percentage in 13 studies, with 100% rate in seven and 63.2–98.0% in six reports. Five studies reported actuarial LC (2-year LC: 70.0–100%). PFS was reported as a crude rate in 11 studies (range 27.3–68.8%). Actuarial 2-year PFS was reported in four studies (range 30.0–50.0%). SBRT tolerability was excellent, with only two patients with grade 3 acute toxicity and two patients with grade 3 late toxicity. SBRT for LN oligorecurrences from PCa in safe and provides optimal LC. However, the long-term effect on PFS and OS is still unclear as well as which patients are the best candidate for this approach.

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Section: Discussionmentioning

confidence: 99%

Stereotactic radiotherapy of nodal oligometastases from prostate cancer: a prisma-compliant systematic review

Zamagni

Bonetti

Buwenge

et al. 2022

Clin Exp Metastasis

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“…Some retrospective studies reported a positive impact of ADT use concomitant to RT [5] , while others showed no benefit [34] , [35] . Another trials investigated RT alone with the aim to defer the onset of ADT [36] . For example, Fodor et al demonstrated that patients with nodal oligorecurrence had 25 to 44 months ADT-free survival time after SBRT of lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Elective nodal radiotherapy with a gapless radiation field junction for oligorecurrent prostate cancer after previous radiotherapy

Li¹,

Yang²,

Trapp³

et al. 2023

Clinical and Translational Radiation Oncology

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“…More specifically, it is very important to update health providers about the recent advances in technology, which have changed dramatically the clinical scenarios in oncology, allowing dose escalation in radiotherapy, decreasing toxicity and treatment duration with improved oncologic outcome and with less impact on patients’ quality of life. Techniques such as intensity-modulated radiation therapy (IMRT)22 or stereotactic radiotherapy5,7,23 create highly conformal dose distributions with steep dose gradients using advanced planning and treatment equipment. Eventually, image-guided radiotherapy (IGRT) permits daily target localization to guide the dose delivery 24.…”

Section: Physician Barriersmentioning

confidence: 99%

<p>Physician And Patient Barriers To Radiotherapy Service Access: Treatment Referral Implications</p>

Chierchini

Ingrosso

Saldi

et al. 2019

CMAR

Self Cite

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Radiotherapy is one of the mainstays of cancer treatment, and about 60% of cancer patients receive this type of treatment during their course of treatment. An evident gap between optimal and actual radiotherapy utilization proportions has recently been reported, which has been ascribed to lack of referral to radiation oncology. There are many factors influencing the radiotherapy referral, including patient anxiety about toxicity, wrong perception of efficacy and side effects by physicians and patients, insufficient knowledge of referral process. These factors, defined as barriers can be categorized in health system barriers, physician and patient barriers. In the present brief narrative review, we discussed barriers to radiotherapy referral focusing on physician and patient barriers.

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Oligorecurrent prostate cancer limited to lymph nodes: getting our ducks in a row

Abstract: Newer PET/CT radio-labeled tracers have increased disease detection in oligorecurrent prostate cancer patients. Growing evidence of their impact on metastasis-directed therapy encourages the use of the most advanced radiotherapy techniques in the clinical management of such patients.

Cited by 18 publications

References 43 publications

Stereotactic radiotherapy of nodal oligometastases from prostate cancer: a prisma-compliant systematic review

Stereotactic radiotherapy of nodal oligometastases from prostate cancer: a prisma-compliant systematic review

Elective nodal radiotherapy with a gapless radiation field junction for oligorecurrent prostate cancer after previous radiotherapy

<p>Physician And Patient Barriers To Radiotherapy Service Access: Treatment Referral Implications</p>

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