BACKGROUND - A new entity of patients with recurrent prostate cancer limited to a small number of active metastatic lesions is having growing interest: the oligometastatic patients. Patients with oligometastatic disease could eventually be managed by treating all the active lesions with local therapy, i.
e. either surgery or ablative stereotactic body radiotherapy. This study aims to assess the impact of [(18)F]Choline ([(18)F]FMCH) PET/CT and the use stereotactic body radiotherapy (SBRT) in patients (pts) with oligometastatic prostate cancer (PCa).
METHODS - Twenty-nine pts with oligometastatic PCa (≤3 synchronous active lesions detected with [(18)F]FMCHPET/CT) were treated with repeated salvage SBRT until disease progression (development of > three active synchronous metastases). Primary endpoint was systemic therapy-free survival measured from the baseline [(18)F]FMCHPET/CT.
RESULTS - A total of 45 lesions were treated with SBRT. After a median follow-up of 11. 5 months (range 3-40 months), 20 pts were still in the study and did not receive any systemic therapy. Nine pts started systemic therapy, and the median time of the primary endpoint was 39. 7 months (CI 12. 20-62. 14 months). No grade 3 or 4 toxicity was recorded.
CONCLUSIONS - Repeated salvage [(18)F]FMCHPET/CT-guided SBRT is well tolerated and could defer the beginning of systemic therapy in selected patients with oligometastatic PCa.
Radiation oncology (London, England). 2016 Jan 22*** epublish ***
Francesco Pasqualetti, Marco Panichi, Aldo Sainato, Fabrizio Matteucci, Luca Galli, Paola Cocuzza, Patrizia Ferrazza, Gabriele Coraggio, Giuseppe Pasqualetti, Lisa Derosa, Martina Sollini, Lorenzo Mannelli, Simona Ortori, Fabio Monzani, Sergio Ricci, Carlo Greco, Maria Grazia Fabrini, Paola Anna Erba
Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Medical Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Humanitas University, Via Manzoni 113, Rozzano, Milano, 20089, Italy. Medical Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Humanitas University, Via Manzoni 113, Rozzano, Milano, 20089, Italy. Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, USA. Radiology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Geriatrics Unit, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Medical Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Radiation Oncology, Champalimaud Centre for the Unknown, Avenida Brasília, 1400-038, Lisboa, Portugal. Radiation Oncology, Azienda Ospedaliero Universitaria Pisana, Via Roma 55, 56126, Pisa, Italy. Department of Translational Research and New Technologies in Medicine, Regional Center of Nuclear Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.