Metastasis-directed stereotactic radiotherapy for oligoprogressive castration-resistant prostate cancer: a multicenter study.

Herein, we report the clinical outcomes of a multicenter study evaluating the role of SBRT in a cohort of patients affected by oligoprogressive castration-resistant prostate cancer (CRPC).

This is a retrospective multicenter observational study including eleven centers. Inclusion criteria of the current study were: (a) Karnofsky performance status > 80, (b) histologically proven diagnosis of PC, (c) 1-5 oligoprogressive metastases, defined as progressive disease at bone or nodes levels (detected by means of choline PET/CT or CT plus bone scan) during ADT, (d) serum testosterone level under 50 ng/ml during ADT, (e) controlled primary tumor, (f) patients treated with SBRT with a dose of at least 5 Gy per fraction to a biologically effective dose (BED) of at least 80 Gy using an alpha-to-beta ratio of 3 Gy, (g) at least 6 months of follow-up post-SBRT.

Eighty-six patients for a total of 117 lesions were treated with SBRT. The median follow-up was 30.7 months (range 4-91 months). The median new metastasis-free survival after SBRT was 12.3 months (95% CI 5.5-19.1 months). One- and two-year distant progression-free survival was 52.3% and 33.7%, respectively. Twenty-six out of 86 patients underwent a second course of SBRT due to further oligoprogressive disease: This resulted in a median systemic treatment-free survival of 21.8 months (95% CI 17.8-25.8 months). One-year systemic treatment-free survival was 72.1%.

SBRT appears to be a promising approach in oligoprogressive castration-resistant prostate cancer. Further investigations are warranted.

World journal of urology. 2019 Mar 11 [Epub ahead of print]

Luca Triggiani, Rosario Mazzola, Stefano Maria Magrini, Gianluca Ingrosso, Paolo Borghetti, Fabio Trippa, Andrea Lancia, Beatrice Detti, Giulio Francolini, Fabio Matrone, Roberto Bortolus, Giuseppe Fanetti, Ernesto Maranzano, Francesco Pasqualetti, Fabiola Paiar, Marco Lorenzo BonĂ¹, Alessandro Magli, Alessio Bruni, Ercole Mazzeo, Ciro Franzese, Marta Scorsetti, Filippo Alongi, Barbara Alicja Jereczek-Fossa, Piet Ost, Michela Buglione

Radiation Oncology Department, University and Spedali Civili Hospital, Brescia, Italy., Radiation Oncology Department, IRCCS, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy. ., Department of Radiation Oncology, Policlinico Tor Vergata, University of Rome, Rome, Italy., Radiation Oncology Centre, "S. Maria" Hospital, Terni, Italy., Department of Radiation Oncology, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy., Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Aviano, PN, Italy., Department of Radiation Oncology, University Hospital S. Chiara, Pisa, Italy., Department of Radiation Oncology, University Hospital of Udine, ASUIUD, Udine, Italy., Radiotherapy Unit, Oncology and Hematology Department, University Hospital of Modena, Modena, Italy., IRCCS, Radiotherapy and Radiosurgery Department, Humanitas University Hospital, Milan-Rozzano, Italy., Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy., Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium.

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