Luca Nicosia1, Ciro Franzese2, Rosario Mazzola1, Davide Franceschini2, Michele Rigo1, Giuseppe D'agostino2, Stefanie Corradini3, Filippo Alongi4,5,6, Marta Scorsetti2. 1. Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy. 2. Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Hospital, Milan-Rozzano, Italy. 3. Radiation Oncology Department, University Hospital, LMU Munich, Munich, Germany. 4. Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy. prof.filippoalongi@gmail.com. 5. University of Brescia, Brescia, Italy. prof.filippoalongi@gmail.com. 6. Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy. prof.filippoalongi@gmail.com.
Abstract
PURPOSE: For patients with oligometastatic/oligorecurrent/oligoprogressive lymph node metastases from PCa, metastases-directed therapy is an emerging strategy. The aim of this retrospective study was to evaluate the oncological outcome and pattern of recurrence in patients treated with stereotactic body radiation therapy (SBRT) to lymph node metastases. METHODS: In this multi-institutional analysis, patients with a maximum of five lymph node metastases from PCa treated with SBRT were included. Primary endpoints of the analysis were local control (LC), out-of-field nodal progression-free survival (NPFS), overall progression-free survival (PFS), and overall survival (OS). RESULTS: 109 patients and 155 lymph node metastases were evaluated. Patients' median age was 70.8 years (range 51-84) and median PSA before SBRT was 1.88 ng/ml (range 0.3-45.5 ng/ml). The dose delivered to the target ranged from 25 to 48 Gy in 4-7 fractions; median BED1.5 Gy was 198 Gy (range 108.3-432 Gy). With a median follow-up of 16 months, LC rates at 1 and 3 years were 93% and 86%, respectively. In-field progression of disease was observed in 11 (7%) lesions. One- and 3‑year NPFS was 59% and 29%, and median NPFS was 15 months. Rates of OS at 1 and 3 years were 100% and 95%. The median time to administration of a systemic treatment after SBRT was 7.8 months (1.7-54.8). CONCLUSION: SBRT is an effective and well-tolerated treatment option in the management of lymph node metastases from PCa. Prospective trials are necessary to better select patients who benefit most from this ablative focal treatment and better define the recurrence patterns.
PURPOSE: For patients with oligometastatic/oligorecurrent/oligoprogressive lymph node metastases from PCa, metastases-directed therapy is an emerging strategy. The aim of this retrospective study was to evaluate the oncological outcome and pattern of recurrence in patients treated with stereotactic body radiation therapy (SBRT) to lymph node metastases. METHODS: In this multi-institutional analysis, patients with a maximum of five lymph node metastases from PCa treated with SBRT were included. Primary endpoints of the analysis were local control (LC), out-of-field nodal progression-free survival (NPFS), overall progression-free survival (PFS), and overall survival (OS). RESULTS: 109 patients and 155 lymph node metastases were evaluated. Patients' median age was 70.8 years (range 51-84) and median PSA before SBRT was 1.88 ng/ml (range 0.3-45.5 ng/ml). The dose delivered to the target ranged from 25 to 48 Gy in 4-7 fractions; median BED1.5 Gy was 198 Gy (range 108.3-432 Gy). With a median follow-up of 16 months, LC rates at 1 and 3 years were 93% and 86%, respectively. In-field progression of disease was observed in 11 (7%) lesions. One- and 3‑year NPFS was 59% and 29%, and median NPFS was 15 months. Rates of OS at 1 and 3 years were 100% and 95%. The median time to administration of a systemic treatment after SBRT was 7.8 months (1.7-54.8). CONCLUSION: SBRT is an effective and well-tolerated treatment option in the management of lymph node metastases from PCa. Prospective trials are necessary to better select patients who benefit most from this ablative focal treatment and better define the recurrence patterns.
Entities:
Keywords:
Metastases-directed therapies; Oligometastasis; Prostate cancer; Radiotherapy; Stereotactic body radiotherapy
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: Francesco A Mistretta; Stefano Luzzago; Andrea Conti; Elena Verri; Giulia Marvaso; Claudia Collà Ruvolo; Michele Catellani; Ettore Di Trapani; Gabriele Cozzi; Roberto Bianchi; Matteo Ferro; Giovanni Cordima; Antonio Brescia; Maria Cossu Rocca; Vincenzo Mirone; Barbara A Jereczek-Fossa; Franco Nolè; Ottavio de Cobelli; Gennaro Musi Journal: Cancers (Basel) Date: 2022-05-06 Impact factor: 6.639
Authors: Irina Filimonova; Daniela Schmidt; Sina Mansoorian; Thomas Weissmann; Hadi Siavooshhaghighi; Alexander Cavallaro; Torsten Kuwert; Christoph Bert; Benjamin Frey; Luitpold Valentin Distel; Sebastian Lettmaier; Rainer Fietkau; Florian Putz Journal: Front Oncol Date: 2021-01-08 Impact factor: 6.244
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: Goda Kalinauskaite; Carolin Senger; Anne Kluge; Christian Furth; Markus Kufeld; Ingeborg Tinhofer; Volker Budach; Marcus Beck; Alexandra Hochreiter; Arne Grün; Carmen Stromberger Journal: PLoS One Date: 2020-10-21 Impact factor: 3.240