Barbara Alicja Jereczek-Fossa1, Giuseppe Fanetti2, Cristiana Fodor3, Delia Ciardo3, Luigi Santoro4, Claudia Maria Francia1, Matteo Muto1, Alessia Surgo1, Dario Zerini3, Giulia Marvaso3, Giorgia Timon3, Paola Romanelli3, Elena Rondi5, Stefania Comi5, Federica Cattani5, Federica Golino3, Stefano Mazza3, Deliu Victor Matei6, Matteo Ferro6, Gennaro Musi6, Franco Nolè7, Ottavio de Cobelli6, Piet Ost8, Roberto Orecchia9. 1. Department of Radiotherapy, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy. 2. Department of Radiotherapy, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy. Electronic address: giuseppe.fanetti@ieo.it. 3. Department of Radiotherapy, European Institute of Oncology, Milan, Italy. 4. Department of Epidemiology and Statistics, European Institute of Oncology, Milan, Italy. 5. Unit of Medical Physics, European Institute of Oncology, Milan, Italy. 6. Department of Urology, European Institute of Oncology, Milan, Italy. 7. Division of Urogenital and Head and Neck Tumours, Department of Medical Oncology, European Institute of Oncology, Milan, Italy. 8. Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium. 9. Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy; Scientific Directorate, European Institute of Oncology, Milan, Italy.
Abstract
BACKGROUND: The purpose of the study was to evaluate the prostate serum antigen (PSA) response, local control, progression-free survival (PFS), and toxicity of stereotactic body radiotherapy (SBRT) for lymph node (LN) oligorecurrent prostate cancer. PATIENTS AND METHODS: Between May 2012 and October 2015, 124 lesions were treated in 94 patients with a median dose of 24 Gy in 3 fractions. Seventy patients were treated for a single lesion and 25 for > 1 lesion. In 34 patients androgen deprivation (AD) was combined with SBRT. We evaluated biochemical response according to PSA level every 3 months after SBRT: a 3-month PSA decrease from pre-SBRT PSA of more than 10% identified responder patients. In case of PSA level increase, imaging was performed to evaluate clinical progression. Toxicity was assessed every 6 to 9 months after SBRT. RESULTS: Median follow-up was 18.5 months. In 13 patients (14%) Grade 1 to 2 toxicity was reported without any Grade 3 to 4 toxicity. Biochemical response, stabilization, and progression were observed in 64 (68%), 10 (11%), and 20 (21%) of 94 evaluable patients. Clinical progression was observed in 31 patients (33%) after a median time of 8.1 months. In-field progression occurred in 12 lesions (9.7%). Two-year local control and PFS rates were 84% and 30%, respectively. Age older than 75 years correlated with better biochemical response rate. Age older than 75 years, concomitant AD administered up to 12 months, and pelvic LN involvement correlated with longer PFS. CONCLUSION: SBRT is safe and offers good in-field control. At 2 years after SBRT, 1 of 3 patients is progression-free. Further investigation is warranted to identify patients who benefit most from SBRT and to define the optimal combination with AD.
BACKGROUND: The purpose of the study was to evaluate the prostate serum antigen (PSA) response, local control, progression-free survival (PFS), and toxicity of stereotactic body radiotherapy (SBRT) for lymph node (LN) oligorecurrent prostate cancer. PATIENTS AND METHODS: Between May 2012 and October 2015, 124 lesions were treated in 94 patients with a median dose of 24 Gy in 3 fractions. Seventy patients were treated for a single lesion and 25 for > 1 lesion. In 34 patients androgen deprivation (AD) was combined with SBRT. We evaluated biochemical response according to PSA level every 3 months after SBRT: a 3-month PSA decrease from pre-SBRT PSA of more than 10% identified responder patients. In case of PSA level increase, imaging was performed to evaluate clinical progression. Toxicity was assessed every 6 to 9 months after SBRT. RESULTS: Median follow-up was 18.5 months. In 13 patients (14%) Grade 1 to 2 toxicity was reported without any Grade 3 to 4 toxicity. Biochemical response, stabilization, and progression were observed in 64 (68%), 10 (11%), and 20 (21%) of 94 evaluable patients. Clinical progression was observed in 31 patients (33%) after a median time of 8.1 months. In-field progression occurred in 12 lesions (9.7%). Two-year local control and PFS rates were 84% and 30%, respectively. Age older than 75 years correlated with better biochemical response rate. Age older than 75 years, concomitant AD administered up to 12 months, and pelvic LN involvement correlated with longer PFS. CONCLUSION: SBRT is safe and offers good in-field control. At 2 years after SBRT, 1 of 3 patients is progression-free. Further investigation is warranted to identify patients who benefit most from SBRT and to define the optimal combination with AD.
Authors: Barbara Alicja Jereczek-Fossa; Barbara Bortolato; Marianna Alessandra Gerardi; Samantha Dicuonzo; Virginia Maria Arienti; Stefania Berlinghieri; Stefano Bracelli; Michela Buglione; Mariangela Caputo; Gianpiero Catalano; Luigi Franco Cazzaniga; Luigi De Cicco; Nadia Di Muzio; Francesco Romeo Filippone; Andrei Fodor; Davide Franceschini; Paolo Frata; Stefania Gottardo; Giovanni Battista Ivaldi; Antonio Laudati; Stefano Maria Magrini; Elisa Mantero; Ilaria Meaglia; Sara Morlino; Mauro Palazzi; Fabio Piccoli; Paola Romanelli; Marta Scorsetti; Flavia Serafini; Luciano Scandolaro; Riccardo Valdagni; Roberto Orecchia; Paolo Antognoni Journal: Radiol Med Date: 2018-12-15 Impact factor: 3.469
Authors: Susanne Stera; Panagiotis Balermpas; Mark K H Chan; Stefan Huttenlocher; Stefan Wurster; Christian Keller; Detlef Imhoff; Dirk Rades; Jürgen Dunst; Claus Rödel; Guido Hildebrandt; Oliver Blanck Journal: Strahlenther Onkol Date: 2017-09-05 Impact factor: 3.621
Authors: V Dell'Acqua; A Surgo; F Kraja; J Kobiela; Maria Alessia Zerella; P Spychalski; S Gandini; C M Francia; D Ciardo; C Fodor; A M Ferrari; G Piperno; F Cattani; S Vigorito; F Pansini; W Petz; R Orecchia; M C Leonardi; B A Jereczek-Fossa Journal: Clin Exp Metastasis Date: 2019-06-04 Impact factor: 5.150
Authors: Andrei Fodor; Andrea Lancia; Francesco Ceci; Maria Picchio; Morten Hoyer; Barbara Alicja Jereczek-Fossa; Piet Ost; Paolo Castellucci; Elena Incerti; Nadia Di Muzio; Gianluca Ingrosso Journal: World J Urol Date: 2018-05-11 Impact factor: 4.226
Authors: Paul Rogowski; Christian Trapp; Rieke von Bestenbostel; Nina-Sophie Schmidt-Hegemann; Run Shi; Harun Ilhan; Alexander Kretschmer; Christian Stief; Ute Ganswindt; Claus Belka; Minglun Li Journal: Radiat Oncol Date: 2021-06-30 Impact factor: 3.481