OBJECTIVE: In contrast to traditional views of incurability, patients with oligometastatic disease present with an opportunity for disease eradication with aggressive treatment. There is mounting evidence in support of the role of stereotactic body radiotherapy (SBRT) in oligometastatic prostate cancer (OMPC). METHODS: MEDLINE and EMBASE were queried for prospective cohort studies reporting the outcomes of metachronous OMPC treated with SBRT. The primary outcome was overall local control. Secondary outcomes included androgen deprivation therapy-free survival (ADTFS), biochemical recurrence free survival (BCFS), and progression-free survival (PFS). When appropriate, these endpoints were combined in a meta-analysis. RESULTS: We screened 356 abstracts and identified 10 studies to include in our analysis, with a total of 653 patients and 1,111 lesions. The maximum number of lesions included in any single study ranged from 3 to 5. PET-CT staging occurred in 92.4% of all patients. SBRT dose varied, with BED1.5 ranging from 152 to 408. Only one Grade 3 bone toxicity was observed. Meta-analysis reported an overall local control rate of 97% (95% CI, 94-100). Median ADTFS was 24.7 months (95% CI, 20.1-29.2 months). Two-year BCFS, PFS, and ADTFS were 33% (95% CI, 11-55), 39% (95% CI, 24-54), and 52% (95%CI, 41-62), respectively. Patients treated with SBRT were half as likely to experience PSA progression than those on observation when looking at randomized control trial data alone. CONCLUSION: SBRT appears to be effective in controlling overall disease burden in metachronous OMPC patients and is associated with minimal significant toxicity. The current prospective literature is scarce, and further prospective data are needed to guide treatment recommendations. ADVANCES IN KNOWLEDGE: This study provides a comprehensive summary of the prospective evidence reporting the outcomes of SBRT in the management of OMPC patients. We quantify the rates of local control, biochemical-free recurrence, progression-free survival, and ADT-free survival through meta-analysis.
OBJECTIVE: In contrast to traditional views of incurability, patients with oligometastatic disease present with an opportunity for disease eradication with aggressive treatment. There is mounting evidence in support of the role of stereotactic body radiotherapy (SBRT) in oligometastatic prostate cancer (OMPC). METHODS: MEDLINE and EMBASE were queried for prospective cohort studies reporting the outcomes of metachronous OMPC treated with SBRT. The primary outcome was overall local control. Secondary outcomes included androgen deprivation therapy-free survival (ADTFS), biochemical recurrence free survival (BCFS), and progression-free survival (PFS). When appropriate, these endpoints were combined in a meta-analysis. RESULTS: We screened 356 abstracts and identified 10 studies to include in our analysis, with a total of 653 patients and 1,111 lesions. The maximum number of lesions included in any single study ranged from 3 to 5. PET-CT staging occurred in 92.4% of all patients. SBRT dose varied, with BED1.5 ranging from 152 to 408. Only one Grade 3 bone toxicity was observed. Meta-analysis reported an overall local control rate of 97% (95% CI, 94-100). Median ADTFS was 24.7 months (95% CI, 20.1-29.2 months). Two-year BCFS, PFS, and ADTFS were 33% (95% CI, 11-55), 39% (95% CI, 24-54), and 52% (95%CI, 41-62), respectively. Patients treated with SBRT were half as likely to experience PSA progression than those on observation when looking at randomized control trial data alone. CONCLUSION: SBRT appears to be effective in controlling overall disease burden in metachronous OMPC patients and is associated with minimal significant toxicity. The current prospective literature is scarce, and further prospective data are needed to guide treatment recommendations. ADVANCES IN KNOWLEDGE: This study provides a comprehensive summary of the prospective evidence reporting the outcomes of SBRT in the management of OMPC patients. We quantify the rates of local control, biochemical-free recurrence, progression-free survival, and ADT-free survival through meta-analysis.
Authors: Jonathan A C Sterne; Jelena Savović; Matthew J Page; Roy G Elbers; Natalie S Blencowe; Isabelle Boutron; Christopher J Cates; Hung-Yuan Cheng; Mark S Corbett; Sandra M Eldridge; Jonathan R Emberson; Miguel A Hernán; Sally Hopewell; Asbjørn Hróbjartsson; Daniela R Junqueira; Peter Jüni; Jamie J Kirkham; Toby Lasserson; Tianjing Li; Alexandra McAleenan; Barnaby C Reeves; Sasha Shepperd; Ian Shrier; Lesley A Stewart; Kate Tilling; Ian R White; Penny F Whiting; Julian P T Higgins Journal: BMJ Date: 2019-08-28
Authors: Alfonso Gomez-Iturriaga; Francisco Casquero Ocio; Piet Ost; Iratxe Fernandez; Emilia Rodeño; Roberto Llarena; Jorge Garcia-Olaverri; Roberto Ortiz de Zarate; Jon Cacicedo; Alina Ahtamon; Pedro Bilbao Journal: Eur J Cancer Care (Engl) Date: 2019-05-21 Impact factor: 2.520
Authors: Shafak S Aluwini; Niven Mehra; Martijn P Lolkema; Daniela E Oprea-Lager; Derya Yakar; Herman Stoevelaar; Henk van der Poel; Martijn Busstra; Igle-Jan de Jong; Theo de Reijke; Kim de Vries; Stijn Heijmink; Guido Jenster; Sjoerd Klaver; Jeroen Kneppers; Jules Lavalaye; Gisèle Leyten; Luc Moonen; James Nagaraj; Walter Noordzij; Susanne Osanto; Irma Oving; Eva Schaake; Tom Scheenen; Ivo Schoots; Michiel Sedelaar; Diederik Somford; Franchette van den Berkmortel; Tom van der Hulle; Jochem van der Voort van Zyp; Pim van Leeuwen; Jeroen van Moorselaar; Inge van Oort; Wouter Vogel; Hans Westgeest Journal: Eur Urol Oncol Date: 2019-08-08
Authors: Piet Ost; Alberto Bossi; Karel Decaestecker; Gert De Meerleer; Gianluca Giannarini; R Jeffrey Karnes; Mack Roach; Alberto Briganti Journal: Eur Urol Date: 2014-09-17 Impact factor: 20.096
Authors: Wassim Abida; Joanna Cyrta; Glenn Heller; Davide Prandi; Joshua Armenia; Ilsa Coleman; Marcin Cieslik; Matteo Benelli; Dan Robinson; Eliezer M Van Allen; Andrea Sboner; Tarcisio Fedrizzi; Juan Miguel Mosquera; Brian D Robinson; Navonil De Sarkar; Lakshmi P Kunju; Scott Tomlins; Yi Mi Wu; Daniel Nava Rodrigues; Massimo Loda; Anuradha Gopalan; Victor E Reuter; Colin C Pritchard; Joaquin Mateo; Diletta Bianchini; Susana Miranda; Suzanne Carreira; Pasquale Rescigno; Julie Filipenko; Jacob Vinson; Robert B Montgomery; Himisha Beltran; Elisabeth I Heath; Howard I Scher; Philip W Kantoff; Mary-Ellen Taplin; Nikolaus Schultz; Johann S deBono; Francesca Demichelis; Peter S Nelson; Mark A Rubin; Arul M Chinnaiyan; Charles L Sawyers Journal: Proc Natl Acad Sci U S A Date: 2019-05-06 Impact factor: 11.205
Authors: Igor Tsaur; Roman A Blaheta; Robert Dotzauer; Cristian Mirvald; Jonathan Olivier; Cristian Surcel; Maximilian P Brandt; Giorgio Gandaglia; Ioanel Sinescu Journal: World J Urol Date: 2022-10-02 Impact factor: 3.661