The first line treatment of metastatic prostate cancer is medical or surgical androgen-deprivation. This treatment however has significant side effects that can affect the patients' quality of life. For oligometastatic patients, a new therapeutic approach, focusing on local treatment of metastases, is emerging.
A systematic review of studies published on Stereotactic Body Radiation Therapy (SBRT) for oligometastatic prostate cancer was performed using results from search request on MEDLINE.
Treatment regimens vary from a single fraction of 20Gy (bone lesions) to ten fractions for a total dose of 64Gy (visceral metastases). Local control is 95.5 to 100% at 2 years with grade 1 and 2 toxicities around 10%, without any grade 3 side effects. These retrospective studies show the feasibility and very low toxicity of SBRT for this population of patients. The effect of SBRT on disease-free or global survival and quality of life has not been assessed. Several prospective trials (STOMP & ORIOLE) are underway.
Treating patients with up to five prostate cancer metastases is efficient and has a low toxicity. Prospective trials should identify which patients, if any, really benefit from this approach.
Bulletin du cancer. 2017 Nov 27 [Epub ahead of print]
Université Paris Descartes, Sorbonne Paris Cité, hôpital Européen Georges Pompidou, service d'oncologie radiothérapie, 20, rue Leblanc, 75015 Paris, France. Electronic address: .