Verane Achard1, Marta Bottero1,2, Michel Rouzaud1, Andrea Lancia3, Marta Scorsetti4,5, Andrea Riccardo Filippi3,6, Ciro Franzese4,5, Barbara Alicja Jereczek-Fossa7,8, Gianluca Ingrosso9, Piet Ost10, Thomas Zilli1,11. 1. Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland. 2. Department of Radiation Oncology, Tor Vergata General Hospital, University of Rome "Tor Vergata", Rome, Italy. 3. Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 4. Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Milan, Italy. 5. Department of Biomedical Sciences, Humanitas University, Milan, Italy. 6. Department of Surgical, Medical and Pediatric Sciences, University of Pavia, Pavia, Italy. 7. Division of Radiotherapy, IEO European Institute of oncology, IRCCS, Milan, Italy. 8. Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy. 9. Radiation Oncology section, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia General Hospital, Perugia, Italy. 10. Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium. 11. Faculty of Medicine, Geneva University, Geneva, Switzerland.
Abstract
BACKGROUND: Radiotherapy is an emerging treatment strategy for nodal oligorecurrent prostate cancer (PCa) patients. However, large heterogeneities exist in the RT regimens used, with series reporting the use of elective nodal radiotherapy (ENRT) strategies and others the delivery of focal treatments to the relapsing nodes with Stereotactic Body Radiotherapy (SBRT). In this systematic review of the literature we compared the oncological outcomes and toxicity of the different RT regimens for nodal oligorecurrent PCa patients, with the aim of defining the optimal RT target volume in this setting. METHODS: We performed a systemic search on the Pubmed database to identify articles reporting on the use of ENRT or SBRT for oligometastatic PCa with nodal recurrence. RESULTS: Twenty-two articles were analyzed, including four prospective phase II trials (3 with SBRT and 1 with ENRT). Focal SBRT, delivered with an involved node, involved site, and involved field modality, was the most commonly used strategy with 2-year progression-free survival (PFS) rates ranging from 16 to 58% and a very low toxicity profile. Improved PFS rates were observed with ENRT strategies (52-80% at 3 years) compared to focal SBRT, despite a slightly higher toxicity rate. One ongoing randomized phase II trial is comparing both modalities in patients with nodal oligorecurrent PCa. CONCLUSIONS: With a large variability in patterns of practice, the optimal RT strategy remains to be determined in the setting of nodal oligorecurrent PCa. Ongoing randomized trials and advances in translational research will help to shed light on the best management for these patients. .
BACKGROUND: Radiotherapy is an emerging treatment strategy for nodal oligorecurrent prostate cancer (PCa) patients. However, large heterogeneities exist in the RT regimens used, with series reporting the use of elective nodal radiotherapy (ENRT) strategies and others the delivery of focal treatments to the relapsing nodes with Stereotactic Body Radiotherapy (SBRT). In this systematic review of the literature we compared the oncological outcomes and toxicity of the different RT regimens for nodal oligorecurrent PCa patients, with the aim of defining the optimal RT target volume in this setting. METHODS: We performed a systemic search on the Pubmed database to identify articles reporting on the use of ENRT or SBRT for oligometastatic PCa with nodal recurrence. RESULTS: Twenty-two articles were analyzed, including four prospective phase II trials (3 with SBRT and 1 with ENRT). Focal SBRT, delivered with an involved node, involved site, and involved field modality, was the most commonly used strategy with 2-year progression-free survival (PFS) rates ranging from 16 to 58% and a very low toxicity profile. Improved PFS rates were observed with ENRT strategies (52-80% at 3 years) compared to focal SBRT, despite a slightly higher toxicity rate. One ongoing randomized phase II trial is comparing both modalities in patients with nodal oligorecurrent PCa. CONCLUSIONS: With a large variability in patterns of practice, the optimal RT strategy remains to be determined in the setting of nodal oligorecurrent PCa. Ongoing randomized trials and advances in translational research will help to shed light on the best management for these patients. .
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; Chukwuka Eze; Ute Ganswindt; Minglun Li; Marcus Unterrainer; Mathias J Zacherl; Harun Ilhan; Leonie Beyer; Alexander Kretschmer; Peter Bartenstein; Christian Stief; Claus Belka; Nina-Sophie Schmidt-Hegemann Journal: Eur J Nucl Med Mol Imaging Date: 2021-10-10 Impact factor: 9.236
Authors: Shafak Aluwini; Daniela E Oprea-Lager; Hilda de Barros; Niven Mehra; Herman Stoevelaar; Derya Yakar; Henk van der Poel Journal: BJUI Compass Date: 2021-02-03