Maurizio Valeriani1, Beatrice Detti2, Andrei Fodor3, Saverio Caini4, Simona Borghesi5, Fabio Trippa6, Luca Triggiani7, Alessio Bruni8, Donatella Russo9, Simonetta Saldi10, Mario Di Staso11, Giulio Francolini12, Andrea Lancia13, Luca Marinelli1, Nadia Di Muzio3, Cynthia Aristei10, Lorenzo Livi12, Stefano Maria Magrini7, Gianluca Ingrosso10. 1. Radiotherapy Oncology Operative Unit, Department of Medicine and Surgery and Translational Medicine, St Andrea Hospital, "Sapienza" University of Rome, Rome, Italy. 2. Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo Brambilla 1, 50134, Florence, Italy. beatrice.detti@aouc.unifi.it. 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, 'S. Maria' Hospital, Terni, Italy. 7. Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy. 8. Radiotherapy Unit, University Hospital of Modena, Modena, Italy. 9. Radiotherapy Unit, Ospedale "Vito Fazzi", Lecce, Italy. 10. Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy. 11. Radiotherapy Unit, "Nuovo San Salvatore" Hospital, L'Aquila, Italy. 12. Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo Brambilla 1, 50134, Florence, Italy. 13. Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Abstract
PURPOSE: To retrospectively estimate the impact of radiotherapy as a progression-directed therapy (PDT) in oligoprogressive metastatic castration-resistant prostate cancer (mCRPC) patients under androgen receptor-target therapy (ARTT). MATERIALS AND METHODS: mCRPC patients are treated with PDT. 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 v4.0. Survival analysis was performed using the Kaplan-Meier method; univariate and multivariate analyses were performed. RESULTS: Fifty-seven patients were analyzed. The median follow-up after PDT was 25.2 months (interquartile, 17.1-44.5). One-year NEST-free survival, r-PFS and OS were 49.8%, 50.4% and 82.1%, respectively. At multivariate analysis, polymetastatic condition at diagnosis of metastatic hormone-sensitive prostate cancer (mHSPC) (HR 2.82, p = 0.004) and PSA doubling time at diagnosis of mCRPC (HR 2.76, p = 0.006) were associated with NEST-free survival. The same variables were associated with r-PFS (HR 2.32, p = 0.021; HR 2.24, p = 0.021). One patient developed late grade ≥ 2 toxicity. CONCLUSION: Our study shows that radiotherapy in oligoprogressive mCRPC is safe, is effective and seems to prolong the efficacy of ARTT in patients who otherwise would have gone systemic treatment switch, positively affecting disease progression. Prospective trials are needed.
PURPOSE: To retrospectively estimate the impact of radiotherapy as a progression-directed therapy (PDT) in oligoprogressive metastatic castration-resistant prostate cancer (mCRPC) patients under androgen receptor-target therapy (ARTT). MATERIALS AND METHODS: mCRPC patients are treated with PDT. 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 v4.0. Survival analysis was performed using the Kaplan-Meier method; univariate and multivariate analyses were performed. RESULTS: Fifty-seven patients were analyzed. The median follow-up after PDT was 25.2 months (interquartile, 17.1-44.5). One-year NEST-free survival, r-PFS and OS were 49.8%, 50.4% and 82.1%, respectively. At multivariate analysis, polymetastatic condition at diagnosis of metastatic hormone-sensitive prostate cancer (mHSPC) (HR 2.82, p = 0.004) and PSA doubling time at diagnosis of mCRPC (HR 2.76, p = 0.006) were associated with NEST-free survival. The same variables were associated with r-PFS (HR 2.32, p = 0.021; HR 2.24, p = 0.021). One patient developed late grade ≥ 2 toxicity. CONCLUSION: Our study shows that radiotherapy in oligoprogressive mCRPC is safe, is effective and seems to prolong the efficacy of ARTT in patients who otherwise would have gone systemic treatment switch, 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: Priyanka H Patel; Nina Tunariu; Daniel S Levine; Johann S de Bono; Rosalind A Eeles; Vincent Khoo; Julia Murray; Christopher C Parker; Angela Pathmanathan; Alison Reid; Nicholas van As; Alison C Tree Journal: Front Oncol Date: 2022-05-17 Impact factor: 5.738