Stereotactic body radiotherapy for castration-sensitive prostate cancer bone oligometastases

• Published in: Medical oncology (Northwood, London, England) Vol. 35; no. 5; pp. 75 - 8
• Main Authors: Fanetti, Giuseppe, Marvaso, Giulia, Ciardo, Delia, Rese, Annaisabel, Ricotti, Rosalinda, Rondi, Elena, Comi, Stefania, Cattani, Federica, Zerini, Dario, Fodor, Cristiana, de Cobelli, Ottavio, Orecchia, Roberto, Jereczek-Fossa, Barbara A.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-05-2018; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Androgen Antagonists - administration & dosage; Bone Neoplasms - diagnosis; Bone Neoplasms - drug therapy; Bone Neoplasms - radiotherapy; Bone Neoplasms - secondary; Combined Modality Therapy; Hematology; Humans; Internal Medicine; Kallikreins - blood; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Orchiectomy; Original Paper; Pathology; Positron Emission Tomography Computed Tomography; Prostate cancer; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - pathology; Prostatic Neoplasms - therapy; Radiation therapy; Radiosurgery; Retrospective Studies; Survival analysis; Stereotactic body radiotherapy; Castration-sensitive prostate cancer; Androgen deprivation therapy; Oligometastases; Prostate cancer; Bone metastases
• ISSN: 1357-0560; 1559-131X
• DOI: 10.1007/s12032-018-1137-0

To evaluate outcome in patients treated with stereotactic body radiotherapy (SBRT) on bone oligometastases from castration-sensitive prostate cancer after primary treatment. We retrospectively collected data of patients with less than five lesions at time of SBRT and hormone-naïve disease at the first extra-regional localization, treated between 03/2012 and 11/2016. Prostate-specific antigen (PSA) was measured every 3 months after SBRT. Imaging was performed in case of progression. Survival analysis was performed with Kaplan–Meier (log-rank test) approach. Fifty-five patients were treated on 77 bone oligometastases. Median age, initial PSA and pre-SBRT PSA were 72 years, 9.12 and 3.5 ng/mL, respectively. Twenty-five patients (45%) received SBRT alone while the remaining 30 patients (55%) received concomitant ADT. Median follow-up was 24.6 months (range 3.0–67.2 months). No acute or late toxicity of grade > 1 was reported. Clinical progression was observed in 38 (69%) patients. 1-year biochemical progression-free survival (b-PFS), clinical progression-free survival (c-PFS), prostate-specific survival (PCSS) and local control (LC) rates were 51, 56, 100 and 83%, respectively. Comparing patients treated with SBRT alone and with concomitant ADT, no significant differences were found for those outcomes. SBRT is safe and allows high 1-year LC rate (83%) with low toxicity profile. No significant improvement in outcomes was registered with the addition of ADT to SBRT.