G Ingrosso1, B Detti2, A Fodor3, S Caini4, S Borghesi5, L Triggiani6, F Trippa7, D Russo8, A Bruni9, G Francolini2, A Lancia10, L Marinelli11, N Di Muzio3, L Livi2, S M Magrini6, E Maranzano7, D Musio8, C Aristei12, M Valeriani11. 1. Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy. ingrosso.gianluca@gmail.com. 2. Department of Radiation Oncology, A.O.U Careggi, University of Florence, Florence, Italy. 3. Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy. 4. Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Networking, Florence, Italy. 5. Unit of Radiation Oncology, S. Donato Hospital, Arezzo, Italy. 6. Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy. 7. Department of Radiation Oncology, 'S. Maria' Hospital, Terni, Italy. 8. Radiotherapy Unit, Ospedale "Vito Fazzi", Lecce, Italy. 9. Radiotherapy Unit, University Hospital of Modena, Modena, Italy. 10. Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 11. Department of Medicine and Surgery and Translational Medicine, "Sapienza" University of Rome, Radiotherapy Oncology Operative Unit, St Andrea Hospital, Rome, Italy. 12. Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy.
Abstract
OBJECTIVES: To report outcomes of stereotactic body radiotherapy (SBRT) in metastatic castration-resistant prostate cancer (mCRPC) patients with oligoprogression (≤ 5 metastases) during first-line treatment with androgen receptor-targeted therapy (ARTT). PATIENTS AND METHODS: Retrospective multi-institutional analysis of mCRPC patients treated with SBRT to oligoprogressive lesions during ARTT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Survival analysis was performed using the Kaplan-Meier method, univariate and multivariate analysis (MVA) were performed. RESULTS: Data from 34 patients were analyzed. Median NEST-free survival, r-PFS, and OS were 16.97, 13.47, and 38.3 months, respectively. At MVA, factors associated with worse NEST-free survival and r-PFS were polymetastatic burden at diagnosis of metastatic hormone-sensitive disease (hazard ratio [HR] 3.66, p = 0.009; HR 3.03, p = 0.034), PSA ≤ 7 ng/ml at mCRPC diagnosis (HR 0.23, p = 0.017; HR 0.19, p = 0.006) and PSADT ≤ 3 months at mCRPC diagnosis (HR 3.39, p = 0.026; HR 2.79, p = 0.037). Polymetastatic state at mHSPC diagnosis was associated with a decreased OS (HR 4.68, p = 0.029). No patient developed acute or late grade ≥ 2 toxicity. CONCLUSION: Our results suggest that SBRT in oligoprogressive mCPRC is safe, effective and seems to prolong the efficacy of the ongoing systemic treatment positively affecting disease progression. Prospective trials are needed.
OBJECTIVES: To report outcomes of stereotactic body radiotherapy (SBRT) in metastatic castration-resistant prostate cancer (mCRPC) patients with oligoprogression (≤ 5 metastases) during first-line treatment with androgen receptor-targeted therapy (ARTT). PATIENTS AND METHODS: Retrospective multi-institutional analysis of mCRPC patients treated with SBRT to oligoprogressive lesions during ARTT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Survival analysis was performed using the Kaplan-Meier method, univariate and multivariate analysis (MVA) were performed. RESULTS: Data from 34 patients were analyzed. Median NEST-free survival, r-PFS, and OS were 16.97, 13.47, and 38.3 months, respectively. At MVA, factors associated with worse NEST-free survival and r-PFS were polymetastatic burden at diagnosis of metastatic hormone-sensitive disease (hazard ratio [HR] 3.66, p = 0.009; HR 3.03, p = 0.034), PSA ≤ 7 ng/ml at mCRPC diagnosis (HR 0.23, p = 0.017; HR 0.19, p = 0.006) and PSADT ≤ 3 months at mCRPC diagnosis (HR 3.39, p = 0.026; HR 2.79, p = 0.037). Polymetastatic state at mHSPC diagnosis was associated with a decreased OS (HR 4.68, p = 0.029). No patient developed acute or late grade ≥ 2 toxicity. CONCLUSION: Our results suggest that SBRT in oligoprogressive mCPRC is safe, effective and seems to prolong the efficacy of the ongoing systemic treatment positively affecting disease progression. Prospective trials are needed.
Authors: Ciro Franzese; Matteo Perrino; Marco Antonio Marzo; Marco Badalamenti; Davide Baldaccini; Giuseppe D'Agostino; Beatrice Marini; Fabio De Vincenzo; Paolo Andrea Zucali; Marta Scorsetti Journal: Clin Exp Metastasis Date: 2022-02-21 Impact factor: 5.150
Authors: Maria Massaro; Giuseppe Facondo; Gianluca Vullo; Anna Maria Aschelter; Alessandro Rossi; Vitaliana De Sanctis; Paolo Marchetti; Mattia Falchetto Osti; Maurizio Valeriani Journal: Front Oncol Date: 2021-09-23 Impact factor: 6.244