Treatment outcomes of metastasis-directed treatment using 68Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002)

Hürmüz, Pervin; Onal, Cem; Özyiğit, Gökhan; Igdem, Sefik; Atalar, Banu; Sayan, Haluk; Akgün, Züleyha; Kurt, Meral; Ozkok, Hale Basak; Selek, Uğur; Oymak, Ezgi; Tilki, Burak; Güler, Ozan Cem; Mustafayev, Teuta Zoto; Saricanbaz, Irem; Rzazade, Rashad; Akyol, Fadıl

doi:10.1007/s00066-020-01660-6

Cited by 29 publications

(66 citation statements)

References 35 publications

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“…This cut-off dose was supported by another study in which a BED > 100 Gy resulted in prolonged systemic treatment-free survival in univariate analysis [ 24 ]. In addition, Hurmuz and colleagues showed a better progression free-survival with a BED > 108 Gy [ 11 ]. Muldermans et al reported a higher 2-year LC rate for SBRT with ≥ 18 Gy compared to 16 Gy (95% vs. 58%, p = 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Whether the number of metastases also has prognostic value within the collective of oligometastatic patients remains unclear. While some studies -possibly underpowered due to small patient cohorts -could not show any influence, the number of metastases had an impact on the outcome in other studies [6][7][8][9][10][11][12].…”

Section: Oligometastatic Prostate Cancer and Outcome Of Mdtmentioning

confidence: 96%

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Radiotherapy of oligometastatic prostate cancer: a systematic review

et al. 2021

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Background Due to improved imaging sensitivity, the term “oligometastatic” prostate cancer disease is diagnosed more often, leading to an increasing interest in metastasis-directed therapy (MDT). There are two types of radiation based MDT applied when treating oligometastatic disease: (1) stereotactic body radiation therapy (SBRT) generally used for bone metastases; or (2) SBRT for isolated nodal oligometastases combined with prophylactic elective nodal radiotherapy. This review aims to summarize current evidence data, which may shed light on the optimal management of this heterogeneous group of patients. Methods A systematic review of the Medline database through PubMed was performed according to PRISMA guidelines. All relevant studies published up to November 2020 were identified and screened. Fifty-six titles were included. Besides outcome parameters, different prognostic and predictive factors were assessed, including site of metastases, time between primary treatment and MDT, use of systemic therapies, hormone sensitivity, as well as pattern of recurrence. Findings Evidence consists largely of retrospective case series and no consistent precise definition of oligometastasis exists, however, most investigators seem to acknowledge the need to distinguish between patients presenting with what is frequently called “synchronous” versus “metachronous” oligometastatic disease. Available data on radiotherapy as MDT demonstrate high local control rates and a small but relevant proportion of patients without progressive disease after 2 years. This holds true for both hormone sensitive and castration resistant prostate cancer diseases. The use of 68Ga-PSMA PET/CT for staging increased dramatically. Radiation doses and field sizes varied considerably among the studies. The search for relevant prognostic and predictive factors is ongoing. Conclusions To our best knowledge this review on oligometastatic prostate cancer included the largest number of original articles. It demonstrates the therapeutic potential and challenges of MDT for oligometastatic prostate cancer. Prospective studies are under way and will provide further high-level evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Oligometastatic Prostate Cancer and Outcome Of Mdtmentioning

confidence: 96%

Radiotherapy of oligometastatic prostate cancer: a systematic review

et al. 2021

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“…44 The role of BED > 100 in improving outcome was also highlighted for PFS. 46,47 A normalized total dose >64 Gy improved three-year bRFS in PCa patients with less than five metastases treated by SABR and ADT. 42 Bowden et al reported 5-year follow-up of a prospective phase II study evaluating SABR for oligometastatic PCa patients with up to 5 lesions.…”

Section: Dovepressmentioning

confidence: 94%

Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer

Franceschini

Teriaca

Dominici

et al. 2021

CMAR

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Oligometastatic patients are a heterogeneous and yet not well-defined population. The actual definition identifies as oligometastatic, patients with 1-5 metastases in 1-3 different organs. However, only a proportion of these patients are "true" oligometastatic and therefore derive some kinds of benefit from local ablative approaches like stereotactic ablative radiation therapy (SABR). Since SABR is an easily accessible, effective and welltolerated treatment, it is widely employed in the oligometastatic scenarios, without a particular focus on selection criteria. However, it should be crucial to identify predictive and prognostic features that could be clinically implemented. Therefore, we conducted this narrative review of the available literature to summarize all clinical, radiomic, genetic and epigenetic features found to be predictive of overall survival, progression-free survival or local control of oligometastatic patients treated with SABR.

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“…Of special relevance in this respect is the identification of distant metastases, mostly to the bone, which can even occur in the group with low-level biochemical recurrence (10 % at a PSA level < 0.5 ng/mL) and in case of oligometastatic disease might be irradiated as well or in more extensive metastatic disease might change the original treatment concept completely [182]. Moreover, adaption of the radiation target volume was noted such as extension of the field to include suspicious lymph nodes or in case of atypically localized recurrences at the border of the standard target volume [183][184][185].…”

Section: Salvage Radiotherapy In Recurrent Prostate Cancermentioning

confidence: 99%

Value of PET imaging for radiation therapy

et al. 2021

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This comprehensive review written by experts in their field gives an overview on the current status of incorporating positron emission tomography (PET) into radiation treatment planning. Moreover, it highlights ongoing studies for treatment individualisation and per-treatment tumour response monitoring for various primary tumours. Novel tracers and image analysis methods are discussed. The authors believe this contribution to be of crucial value for experts in the field as well as for policy makers deciding on the reimbursement of this powerful imaging modality.

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Treatment outcomes of metastasis-directed treatment using 68Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002)

Cited by 29 publications

References 35 publications

Radiotherapy of oligometastatic prostate cancer: a systematic review

Radiotherapy of oligometastatic prostate cancer: a systematic review

Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer

Value of PET imaging for radiation therapy

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