Cem Onal1, Gokhan Ozyigit2, Zuleyha Akgun3, Banu Atalar4, Sefik Igdem5, Ezgi Oymak6, Fulya Agaoglu7, Ugur Selek8, Ozan Cem Guler1, Pervin Hurmuz2, Teuto Zoto Mustafayev4, Fadil Akyol2. 1. From the Department of Radiation Oncology, Adana Dr Turgut Noyan Research and Treatment Center, Baskent University Faculty of Medicine, Adana. 2. Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara. 3. Division of Radiation Oncology, Memorial Sisli Hospital. 4. Department of Radiation Oncology, Acibadem MAA University Maslak Hospital. 5. Department of Radiation Oncology, Istanbul Bilim University, Istanbul. 6. Division of Radiation Oncology, Iskenderun Gelisim Hospital, Hatay. 7. Department of Radiation Oncology, Acibadem MAA University Atakent Hospital. 8. Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.
Abstract
PURPOSE: To evaluate the outcomes of metastasis-directed treatment (MDT) using stereotactic body radiotherapy (SBRT) for bone-only oligometastasis (OM) detected with gallium prostate-specific membrane antigen (68Ga-PSMA) PET/CT in castration-sensitive prostate cancer (PC) patients. METHODS: In this multi-institutional study, clinical data of 74 PC patients with 153 bone lesions who were undergoing MDT were retrospectively evaluated. Twenty-seven patients (36.5%) had synchronous, and 47 (63.5%) had metachronous OM. All patients had PC with 5 metastases or fewer detected by 68Ga-PSMA PET/CT and treated using SBRT with a median dose of 20 Gy. The prognostic factors for PC-specific survival (PCSS) and progression-free survival (PFS) were analyzed. RESULTS: The median follow-up was 27.3 months. Patients with synchronous OM were older and received higher rates of androgen deprivation therapy after SBRT compared with patients with metachronous OM. The 2-year PCSS and PFS rates were 92.0% and 72.0%, respectively. A prostate-specific antigen (PSA) decline was observed in 56 patients (75.7%), and 48 (64.9%) had a PSA response defined as at least 25% decrease of PSA after MDT. The 2-year local control rate per lesion was 95.4%. In multivariate analysis, single OM and PSA response after MDT were significant predictors for better PCSS and PFS. In-field recurrence was observed in 4 patients (6.5%) with 10 lesions at a median of 13.1 months after MDT completion. No serious late toxicity was observed. CONCLUSIONS: We demonstrated that SBRT is an efficient and well-tolerated treatment option for PC patients with 5 bone-only oligometastases or fewer detected with 68Ga-PSMA PET/CT.
PURPOSE: To evaluate the outcomes of metastasis-directed treatment (MDT) using stereotactic body radiotherapy (SBRT) for bone-only oligometastasis (OM) detected with gallium prostate-specific membrane antigen (68Ga-PSMA) PET/CT in castration-sensitive prostate cancer (PC) patients. METHODS: In this multi-institutional study, clinical data of 74 PC patients with 153 bone lesions who were undergoing MDT were retrospectively evaluated. Twenty-seven patients (36.5%) had synchronous, and 47 (63.5%) had metachronous OM. All patients had PC with 5 metastases or fewer detected by 68Ga-PSMA PET/CT and treated using SBRT with a median dose of 20 Gy. The prognostic factors for PC-specific survival (PCSS) and progression-free survival (PFS) were analyzed. RESULTS: The median follow-up was 27.3 months. Patients with synchronous OM were older and received higher rates of androgen deprivation therapy after SBRT compared with patients with metachronous OM. The 2-year PCSS and PFS rates were 92.0% and 72.0%, respectively. A prostate-specific antigen (PSA) decline was observed in 56 patients (75.7%), and 48 (64.9%) had a PSA response defined as at least 25% decrease of PSA after MDT. The 2-year local control rate per lesion was 95.4%. In multivariate analysis, single OM and PSA response after MDT were significant predictors for better PCSS and PFS. In-field recurrence was observed in 4 patients (6.5%) with 10 lesions at a median of 13.1 months after MDT completion. No serious late toxicity was observed. CONCLUSIONS: We demonstrated that SBRT is an efficient and well-tolerated treatment option for PC patients with 5 bone-only oligometastases or fewer detected with 68Ga-PSMA PET/CT.
Authors: Philip Sutera; Ryan M Phillips; Matthew Deek; Gokhan Ozyigit; Cem Onal; Phuoc T Tran Journal: J Nucl Med Date: 2022-01-20 Impact factor: 10.057
Authors: Pierpaolo Alongi; Riccardo Laudicella; Helena Lanzafame; Andrea Farolfi; Paola Mapelli; Maria Picchio; Irene A Burger; Andrei Iagaru; Fabio Minutoli; Laura Evangelista Journal: Cancers (Basel) Date: 2022-03-31 Impact factor: 6.639