Stereotactic body radiotherapy in oligometastatic prostate cancer patients with isolated lymph nodes involvement: a two-institution experience

Ingrosso, Gianluca; Trippa, Fabio; Maranzano, Ernesto; Carosi, Alessandra; Ponti, Elisabetta; Arcidiacono, Fabio; Draghini, Lorena; Murro, Luana Di; Lancia, Andrea; Santoni, Riccardo

doi:10.1007/s00345-016-1860-0

Cited by 60 publications

(97 citation statements)

References 15 publications

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“…Nevertheless, in a mixed population of 20 patients with abdominal metastases from miscellaneous primary tumors receiving SBRT in 1 to 3 fractions, grade 1-2 gastrointestinal acute toxicity ranged from 55% in upper abdominal sites to 6% in pelvic localizations [10]. Consistently with this result, the predominant involvement (81%) of pelvic lymph nodes in the present cohort might explain the low incidence of acute toxicity in study cohort, that is comparable to acute grade 1-2 toxicity rates in papers using multiple fraction regimens [2,3,4,5]. Another strong point in favor of the use of multiple-fraction SBRT is the possibility to deliver higher total doses to the target.…”

Section: Discussionsupporting

confidence: 77%

“…Advances in metabolic imaging currently allow the detection of active foci of the disease at the time of its biochemical recurrence: by consequence, selected patients with a limited burden of disease (oligometastatic) might be eligible for locoregional treatments [1]. In the event of lymph nodal relapse, stereotactic body RT (SBRT) emerged as a valuable option allowing for non-invasive precise tumor targeting, resulting in promising efficacy and low toxicity: reports from multiple institutions showed 2-years progression free survival of 30-44% and rare severe complications [2,3,4,5]. To the authors' knowledge, in all published experiences a multi-fractionated dose regimen was adopted in order to reduce toxicity to abdominal organs.…”

Section: Introductionmentioning

confidence: 99%

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Single-Fraction Stereotactic Body Radiotherapy for Oligometastatic Lymph Node Relapse in Prostate Cancer

Loi¹,

Cataldo²,

Bonomo³

et al. 2018

Oncol Res Treat

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Background: Stereotactic body radiotherapy (SBRT) emerged as a treatment option in oligometastatic (≤3 metastases) patients experiencing lymph node relapse from treated prostate cancer. No recommendations are available concerning dose schedule, and available studies report the use of multiple-fraction regimens due to theoretical lower toxicity and higher cumulative dose delivered to the target. The aim of the present study was to evaluate the safety and efficacy of a dose-intensive, single-fraction SBRT regimen. Patients and Methods: Retrospective data on outcome and toxicity from 27 treatments on 23 consecutive patients were collected. Statistical analysis was performed. Results: Median follow-up was 22 months (range 6-63, interquartile range 15-28). Biochemical progression-free survival (bPFS) at 6 months, 1 year, and 2 years were 65%, 40%, and 26%, respectively. In 2 cases acute toxicity of grade 1 were observed. Conclusion: Single-fraction SBRT for lymph node relapse of oligometastatic prostate cancer resulted in promising biochemical control with minimal toxicity.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Single-Fraction Stereotactic Body Radiotherapy for Oligometastatic Lymph Node Relapse in Prostate Cancer

Loi¹,

Cataldo²,

Bonomo³

et al. 2018

Oncol Res Treat

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show abstract

“…Outcome ADT-FS, the primary outcome, was defined as the time between the first day of SBRT and start of ADT [12,14,15,17]. For the comparison of the ADT-FS between SBRT and non-SBRT treated patient,…”

Section: Radiation Therapymentioning

confidence: 99%

“…Emerging evidence suggests that treatment of single metastases with SBRT might prolong progression free survival (PFS) and allows deferred start of ADT (11)(12)(13)(14)(15), thereby avoiding the related side effects. SBRT has been associated with low levels of toxicity in prostate cancer patients irradiated for bone or lymph node metastases (16,17).…”

Section: Introductionmentioning

confidence: 99%

Benefits of Using Stereotactic Body Radiotherapy in Patients With Metachronous Oligometastases of Hormone-Sensitive Prostate Cancer Detected by [18F]fluoromethylcholine PET/CT

Bouman-Wammes¹,

Jong

Dahele

et al. 2017

Clinical Genitourinary Cancer

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“…The exclusion reasons with references are listed in Data S2. Finally, 14 articles were selected for data extraction and subsequent qualitative synthesis.…”

Section: Resultsmentioning

confidence: 99%

Use of stereotactic body radiation therapy for oligometastatic recurrent prostate cancer: A systematic review

et al. 2018

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The purpose of this study is to evaluate the effectiveness and safety of stereotactic body radiation therapy (SBRT) in the management of oligometastatic recurrent prostate cancer (PCa) by means of a systematic review. Six databases were searched (CENTRAL, Embase, LILACS, PubMed, Scopus and Web of Science). Additionally, hand-searching and grey literature search were performed. The main outcomes were progression-free survival (PFS) and toxicity rates. Androgen deprivation therapy-free survival (ADT-FS), local control, pattern of recurrence, cancer-specific survival and overall survival were also assessed. Risk of bias and quality of evidence were judged with the aid of specific tools. Fourteen studies were included, involving 661 patients and 899 lesions (561 nodal, 336 bone, 2 liver). Median PFS and ADT-FS were around 1 to 3 years. Local control rates varied from 82 to 100% among researches with low risk of bias. Acute and late grade 2 toxicity was observed in 2.4% and 1.1% of the patients, respectively. One case of acute and two cases of late grade 3 toxicity were registered. Only one randomized study addresses this topic. Although it does not meet all the eligibility criteria, it is useful for the discussion. A quantitative analysis was not possible, nor were subgroup analyses, due to the significant heterogeneity of the interventions and outcomes reported. Longer follow-up period is required. SBRT seems to be a safe approach to metastatic lesions that might provide disease control and defer androgen deprivation therapy (ADT). Local control is better when higher radiation doses are employed.

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Stereotactic body radiotherapy in oligometastatic prostate cancer patients with isolated lymph nodes involvement: a two-institution experience

Abstract: Our study demonstrates that SBRT is safe, effective, and minimally invasive in the eradication of limited nodal metastases, yielding an important delay in prescribing ADT.

Cited by 60 publications

References 15 publications

Single-Fraction Stereotactic Body Radiotherapy for Oligometastatic Lymph Node Relapse in Prostate Cancer

Single-Fraction Stereotactic Body Radiotherapy for Oligometastatic Lymph Node Relapse in Prostate Cancer

Benefits of Using Stereotactic Body Radiotherapy in Patients With Metachronous Oligometastases of Hormone-Sensitive Prostate Cancer Detected by [18F]fluoromethylcholine PET/CT

Use of stereotactic body radiation therapy for oligometastatic recurrent prostate cancer: A systematic review

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