OBJECTIVES: The objective of this study was to report long-term results of elective nodal radiotherapy (ENRT) in prostate cancer (PCa) patients with oligorecurrent nodal disease after primary treatment. METHODS: Data of 53 oligorecurrent PCa patients (N1 and/or M1a) with ≤5 nodal metastases (n=108) treated with ENRT combined with androgen deprivation therapy (ADT) between 2004 and 2016 were retrospectively reviewed. Median prostate-specific antigen (PSA) and PSA doubling time (DT) were 3.4 ng/mL and 5 months, respectively. At restaging, 45% of the patients presented single nodal metastases, mainly located in the pelvis (n=38). All patients underwent ENRT between 45 and 50.4 Gy with a boost on positive nodes (median 64.4 Gy; 54 to 69 Gy) using mainly VMAT (n=24) or IMRT (n=21) techniques. Concomitant ADT was administered to all patients for a median time of 6 months. RESULTS: After a median follow-up after ENRT of 44 months (range, 2 to 133), the 5-year biochemical disease-free and distant progression-free survival (DPFS) rates were 43% and 58%, respectively, with worse DPFS observed in patients with a PSA-doubling time <3 months (36.8% vs. 63.6%; P=0.029). Seventeen of 19 clinically relapsing patients presented lesions out of the ENRT field, and 10 were again oligometastatic. Only 2 patients presented with a CTCAE v3.0 grade ≥2 genitourinary toxicity. CONCLUSIONS: ENRT combined with short-course ADT is a safe and effective salvage modality for patients with oligorecurrent nodal PCa. Prospective randomized studies comparing focal SBRT versus ENRT are warranted to define the best treatment strategy.
OBJECTIVES: The objective of this study was to report long-term results of elective nodal radiotherapy (ENRT) in prostate cancer (PCa) patients with oligorecurrent nodal disease after primary treatment. METHODS: Data of 53 oligorecurrent PCa patients (N1 and/or M1a) with ≤5 nodal metastases (n=108) treated with ENRT combined with androgen deprivation therapy (ADT) between 2004 and 2016 were retrospectively reviewed. Median prostate-specific antigen (PSA) and PSA doubling time (DT) were 3.4 ng/mL and 5 months, respectively. At restaging, 45% of the patients presented single nodal metastases, mainly located in the pelvis (n=38). All patients underwent ENRT between 45 and 50.4 Gy with a boost on positive nodes (median 64.4 Gy; 54 to 69 Gy) using mainly VMAT (n=24) or IMRT (n=21) techniques. Concomitant ADT was administered to all patients for a median time of 6 months. RESULTS: After a median follow-up after ENRT of 44 months (range, 2 to 133), the 5-year biochemical disease-free and distant progression-free survival (DPFS) rates were 43% and 58%, respectively, with worse DPFS observed in patients with a PSA-doubling time <3 months (36.8% vs. 63.6%; P=0.029). Seventeen of 19 clinically relapsing patients presented lesions out of the ENRT field, and 10 were again oligometastatic. Only 2 patients presented with a CTCAE v3.0 grade ≥2 genitourinary toxicity. CONCLUSIONS: ENRT combined with short-course ADT is a safe and effective salvage modality for patients with oligorecurrent nodal PCa. Prospective randomized studies comparing focal SBRT versus ENRT are warranted to define the best treatment strategy.
Authors: Verane Achard; Giorgio Lamanna; Antoine Denis; Thomas De Perrot; Ismini Charis Mainta; Osman Ratib; Christophe Iselin; Raymond Miralbell; Valentina Garibotto; Thomas Zilli Journal: Med Oncol Date: 2019-06-12 Impact factor: 3.064
Authors: Frédéric Bois; Camille Noirot; Sébastien Dietemann; Ismini C Mainta; Thomas Zilli; Valentina Garibotto; Martin A Walter Journal: Am J Nucl Med Mol Imaging Date: 2020-12-15
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
Authors: A De Bruycker; A Spiessens; P Dirix; N Koutsouvelis; I Semac; N Liefhooghe; A Gomez-Iturriaga; W Everaerts; F Otte; A Papachristofilou; M Scorsetti; M Shelan; S Siva; F Ameye; M Guckenberger; R Heikkilä; P M Putora; A Zapatero; A Conde-Moreno; F Couñago; F Vanhoutte; E Goetghebeur; D Reynders; T Zilli; P Ost Journal: BMC Cancer Date: 2020-05-12 Impact factor: 4.430
Authors: Simon Kirste; Stephanie G C Kroeze; Christoph Henkenberens; Nina-Sophie Schmidt-Hegemann; Marco M E Vogel; Jessica Becker; Constantinos Zamboglou; Irene Burger; Thorsten Derlin; Peter Bartenstein; Juri Ruf; Christian la Fougère; Matthias Eiber; Hans Christiansen; Stephanie E Combs; Arndt-Christian Müller; Claus Belka; Matthias Guckenberger; Anca-Ligia Grosu Journal: Front Oncol Date: 2021-05-10 Impact factor: 6.244