Stereotactic ablative radiotherapy in castration‑resistant prostate cancer patients with oligoprogression during androgen receptor‑targeted therapy

• G. Ingrosso ^[1] ; B. Detti ^[2] ; A. Fodor ^[3] ; S. Caini ^[4] ; S. Borghesi ^[5] ; L. Triggiani ^[6] ; F. Trippa ^[7] ; D. Russo ^[8] ; A. Bruni ^[9] ; G. Francolini ^[2] ; A. Lancia ^[10] ; L. Marinelli ^[11] ; N. Di Muzio ^[3] ; L. Livi ^[2] ; S. M. Magrini ^[6] ; E. Maranzano ^[7] ; D. Musio ^[3] ; C. Aristei ^[1] ; M. Valeriani ^[1]
  1. [1] Università di Perugia

     Università di Perugia

     Perusa, Italia

     
  2. [2] University of Florence

     University of Florence

     Firenze, Italia

     
  3. [3] Department of Radiation Oncology, San Rafaele Scientifc Institute, Milan, Italy
  4. [4] Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Networking, Florence, Italy
  5. [5] Unit of Radiation Oncology, S. Donato Hospital, Arezzo, Italy
  6. [6] Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
  7. [7] Department of Radiation Oncology, ‘S. Maria’ Hospital, Terni, Italy
  8. [8] Radiotherapy Unit, Ospedale “Vito Fazzi”, Lecce, Italy
  9. [9] Radiotherapy Unit, University Hospital of Modena, Modena, Italy
  10. [10] Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
  11. [11] Department of Medicine and Surgery and Translational Medicine, “Sapienza” University of Rome, Radiotherapy Oncology Operative Unit, St Andrea Hospital, Rome, Italy

  Mostrar afiliaciones +
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 23, Nº. 8, 2021, págs. 1577-1584
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Objectives To report outcomes of stereotactic body radiotherapy (SBRT) in metastatic castration-resistant prostate cancer (mCRPC) patients with oligoprogression (≤5 metastases) during frst-line treatment with androgen receptor-targeted therapy (ARTT).

    Patients and methods Retrospective multi-institutional analysis of mCRPC patients treated with SBRT to oligoprogressive lesions during ARTT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Survival analysis was performed using the Kaplan–Meier method, univariate and multivariate analysis (MVA) were performed.

    Results Data from 34 patients were analyzed. Median NEST-free survival, r-PFS, and OS were 16.97, 13.47, and 38.3 months, respectively. At MVA, factors associated with worse NEST-free survival and r-PFS were polymetastatic burden at diagnosis of metastatic hormone-sensitive disease (hazard ratio [HR] 3.66, p=0.009; HR 3.03, p=0.034), PSA≤7 ng/ml at mCRPC diagnosis (HR 0.23, p=0.017; HR 0.19, p=0.006) and PSADT≤3 months at mCRPC diagnosis (HR 3.39, p=0.026; HR 2.79, p=0.037). Polymetastatic state at mHSPC diagnosis was associated with a decreased OS (HR 4.68, p=0.029). No patient developed acute or late grade≥2 toxicity.

    Conclusion Our results suggest that SBRT in oligoprogressive mCPRC is safe, efective and seems to prolong the efcacy of the ongoing systemic treatment positively afecting disease progression. Prospective trials are needed