S Scharl1, B Hadaschik2, T Wiegel3, C Thomas4. 1. Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland. sophia.scharl@uniklinik-ulm.de. 2. Klinik und Poliklinik für Urologie, Kinderurologie und Uroonkologie, Universitätsklinikum Essen, Essen, Deutschland. 3. Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland. 4. Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland.
Abstract
BACKGROUND: Multimodal treatment concepts are gaining in importance in the treatment of prostate cancer patients with primary oligometastatic disease. Data from randomized studies show that survival advantages can be achieved in this patient collective by the combination of local and systemic treatment compared to systemic treatment alone. OBJECTIVE: To analyze the available data on therapeutic approaches for oligometastatic prostate cancer. MATERIAL AND METHODS: Summary and discussion of current studies on systemic and local treatment of de novo oligometastatic prostate cancer. RESULTS: Systemic treatment continues to be the standard of care in the oligometastatic stage of prostate cancer. Furthermore, irradiation of the prostate is recommended for patients with a low metastasis burden after this led to an extension of the overall survival in a randomized phase III study. Large case series suggest that radical prostatectomy can also improve oncological endpoints. The results of prospective phase II studies on metachronous metastatic disease provide evidence that local ablative radiotherapy of individual metastases can improve progression-free survival; however, the value of this approach in de novo metastatic disease is just as unclear as that of a triple treatment combination consisting of local and extended systemic treatment. CONCLUSION: In addition to systemic treatment, irradiation of the prostate is a new standard of care for the oligometastatic stage ("low tumour burden").
BACKGROUND: Multimodal treatment concepts are gaining in importance in the treatment of prostate cancer patients with primary oligometastatic disease. Data from randomized studies show that survival advantages can be achieved in this patient collective by the combination of local and systemic treatment compared to systemic treatment alone. OBJECTIVE: To analyze the available data on therapeutic approaches for oligometastatic prostate cancer. MATERIAL AND METHODS: Summary and discussion of current studies on systemic and local treatment of de novo oligometastatic prostate cancer. RESULTS: Systemic treatment continues to be the standard of care in the oligometastatic stage of prostate cancer. Furthermore, irradiation of the prostate is recommended for patients with a low metastasis burden after this led to an extension of the overall survival in a randomized phase III study. Large case series suggest that radical prostatectomy can also improve oncological endpoints. The results of prospective phase II studies on metachronous metastatic disease provide evidence that local ablative radiotherapy of individual metastases can improve progression-free survival; however, the value of this approach in de novo metastatic disease is just as unclear as that of a triple treatment combination consisting of local and extended systemic treatment. CONCLUSION: In addition to systemic treatment, irradiation of the prostate is a new standard of care for the oligometastatic stage ("low tumour burden").
Authors: Kim N Chi; Neeraj Agarwal; Anders Bjartell; Byung Ha Chung; Andrea J Pereira de Santana Gomes; Robert Given; Álvaro Juárez Soto; Axel S Merseburger; Mustafa Özgüroğlu; Hirotsugu Uemura; Dingwei Ye; Kris Deprince; Vahid Naini; Jinhui Li; Shinta Cheng; Margaret K Yu; Ke Zhang; Julie S Larsen; Sharon McCarthy; Simon Chowdhury Journal: N Engl J Med Date: 2019-05-31 Impact factor: 91.245
Authors: Kim N Chi; Simon Chowdhury; Anders Bjartell; Byung Ha Chung; Andrea J Pereira de Santana Gomes; Robert Given; Alvaro Juárez; Axel S Merseburger; Mustafa Özgüroğlu; Hirotsugu Uemura; Dingwei Ye; Sabine Brookman-May; Suneel D Mundle; Sharon A McCarthy; Julie S Larsen; Weili Sun; Katherine B Bevans; Ke Zhang; Nibedita Bandyopadhyay; Neeraj Agarwal Journal: J Clin Oncol Date: 2021-04-29 Impact factor: 44.544
Authors: Karim Fizazi; NamPhuong Tran; Luis Fein; Nobuaki Matsubara; Alfredo Rodriguez-Antolin; Boris Y Alekseev; Mustafa Özgüroğlu; Dingwei Ye; Susan Feyerabend; Andrew Protheroe; Peter De Porre; Thian Kheoh; Youn C Park; Mary B Todd; Kim N Chi Journal: N Engl J Med Date: 2017-06-04 Impact factor: 91.245