Prognostic factors influencing prostate cancer‐specific survival in non‐castrate patients with metastatic prostate cancer

Ost, Piet; Decaestecker, Karel; Lambert, Bieke; Fonteyne, Valérie; Delrue, Louke; Lumen, Nicolaas; Ameye, Filip; Meerleer, Gert De

doi:10.1002/pros.22750

Cited by 128 publications

(82 citation statements)

References 36 publications

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“…Also in our group OS was better than reported by Singh D. et al which suggest that use of SRS/SABR can result in prolongation of patients life despite other treatment options used [3]. Ost P et al reported that number of metastases correlates with OS and patients with only 1 lesion had 5-year OS of 90% (compared to 35% for patients with more than one lesion) but this correlation was of statistical significance in our group only in univariate analysis [15]. Published reports concerning local control of lesions after SRS/SABR are very promising.…”

Section: Discussioncontrasting

confidence: 61%

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Napieralska¹,

Miszczyk²,

Stąpór-Fudzińska³

2016

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The aim of the study was to evaluate the effectiveness and toxicity of CyberKnife (CK) stereotactic radiosurgery (SRS) and stereotactic ablative radiation therapy (SABR) of patients with prostate cancer bone metastases. Analysis of prognostic and predictive factors was also performed.Material consisted of 51 patients with 71 bone oligometastases treated using CK SRS/SABR. In half of the patients single lesion was treated, in half 2-5 lesions. Median PSA concentration at the time of metastasis detection was 5.75 ng/ml. Total dose of 6-45Gy (median 20) was delivered with 1-5 fractions of 6-15 Gy (median 9). Biologic equivalent dose (BED) (α/ β=1.6) over 100 Gy was delivered to 45 lesions (63%) in 38 patients (75%).In statistical analysis Kaplan-Meier method, log-rank test and the Cox proportional hazard model were used. One-, two-and three-year overall survival (OS) was 90%, 76% and 70%, respectively. All patients having PSA concentration lower that 1 ng/ml at last control lived at least three years. One-, two-and three-year local control (LC) was 97%, 70% and 30%. Patients with PSA below 20 ng/ml at the time of metastasis detection had better local control of lesions and lower PSA at the last control. Median of PSA concentration after CK based SRS/SABR remains stable during first 12 months of follow-up, dropped during the next months and at last control was comparable to initial level. Median PSA at last control in patients without disease progression was 1.67ng/ml and 20 patients had PSA below 1.0ng/ml. At the last control 59% of patients had no other metastases. Rapid pain decrease was observed in analysed group and during each control about 90% of patients had pain relief. No major toxicity was observed, 3 patients suffered from fracture of irradiated bone. SRS/SABR of prostate cancer bone oligometastases provides good LC of lesions, excellent pain control without additional toxicity. Patients with PSA concentration below 20ng/ml at the time of metastasis detection have better LC and PSA concentration response.

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Section: Discussioncontrasting

confidence: 61%

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Napieralska¹,

Miszczyk²,

Stąpór-Fudzińska³

2016

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“…Patients with local recurrence [7] and patients with a limited number of metastases, so-called oligometastatic patients, have a much better prognosis than patients with extensive metastatic disease, as the oligometastatic cancer state is considered to be an intermediate state of tumour spread with limited metastatic capacity and less aggressive behaviour [8]. In analogy with other solid tumours, eradication of these tumour manifestations by means of metastases directed therapy (MDT) with radiotherapy is an emerging way to delay disease progression and postpone systemic treatment without major treatment toxicity [9].…”

Section: Introductionmentioning

confidence: 99%

68Ga-PSMA ligand PET/CT-based radiotherapy in locally recurrent and recurrent oligometastatic prostate cancer

et al. 2016

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“…There have been studies that suggest hormone-sensitive prostate cancer with oligometastasis may well be eligible for a similar approach given the remarkably favourable prognosis observed in men with oligometastasis. 12,13 Recently, a possible survival benefit of local therapy combined with ADT in metastatic patients has emerged. 14 Two review studies suggested that local or metastatic-directed radiotherapy are reasonable interventions as toxicity is minimal and decreases the necessity for subsequent palliative treatments.…”

Section: Cuaj -Case Series Cho Et Al: Testicular Oligometastasis Frommentioning

confidence: 99%

Case: Testicular oligometastasis from prostate cancer — Report of rare isolated recurrence after radiotherapy and intermittent androgen-deprivation therapy

Cho

Sigurdson

Davidson

et al. 2017

CUAJ

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Testicular oligometastasis secondary to prostate cancer is rare. We present a case where a patient with locally advanced prostate cancer was treated with high-dose external beam radiotherapy and two years of androgen-deprivation therapy, followed by intermittent androgen suppression. Three and a half years after initial diagnosis, he was found to have a painless testicular mass. Orchiectomy was performed and histopathology demonstrated metastatic prostatic adenocarcinoma. He remains in clinical remission on intermittent androgen suppression eight years following initial treatment, and over four years after presentation with testicular metastasis. CaseA 61-year-old Caucasian male presented to his family physician for urinary frequency and nocturia in 2008. He denied gross hematuria, dysuria, or any changes in stool or bowel function. Serum prostate-specific antigen (PSA) level was 20.3 ng/mL, which led to a prostate biopsy. Histopathology showed adenocarcinoma with a Gleason score of 4+5 (9/ 10) involving 80% of the tissue submitted. There was no extraprostatic, perineural, lymphatic, or vascular spread. A computed tomography (CT) scan of the abdomen and pelvis was performed for staging and showed left obturator lymphadenopathy, without evidence of distant metastasis. Excisional biopsy confirmed the presence of metastatic prostate carcinoma in this obturator node. On examination, he had a markedly enlarged prostate in keeping with a T3a lesion. Therefore, his prostate cancer was staged as T3a N1 M0.He commenced androgen deprivation therapy (ADT) with an anti-androgen agent followed by luteinizing hormone-releasing hormone (LHRH) agonist in 2008, followed by a course of external beam radiation therapy delivered with a dose of 7000 cGy in 35 fractions. His PSA nadir in 2009 was 0.1 ng/mL. After 2 years of ADT, he opted for intermittent androgen

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Prognostic factors influencing prostate cancer‐specific survival in non‐castrate patients with metastatic prostate cancer

Abstract: A longer PSA DT, involvement of nodes or axial skeleton and a lower number of metastases are associated with an improved PCSS in non-castrated patients developing metastases.

Cited by 128 publications

References 36 publications

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

68Ga-PSMA ligand PET/CT-based radiotherapy in locally recurrent and recurrent oligometastatic prostate cancer

Case: Testicular oligometastasis from prostate cancer — Report of rare isolated recurrence after radiotherapy and intermittent androgen-deprivation therapy

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