Resumen de Stereotactic ablative radiotherapy in castration‑resistant prostate cancer patients with oligoprogression during androgen receptor‑targeted therapy
G. Ingrosso, B. Detti, A. Fodor, S. Caini, S. Borghesi, L. Triggiani, F. Trippa, D. Russo, A. Bruni, G. Francolini, A. Lancia, L. Marinelli, N. Di Muzio, L. Livi, S. M. Magrini, Ernesto Maranzano, D. Musio, C. Aristei, M. Valeriani
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
