Image-guided Stereotactic Body Radiotherapy in Metastatic Prostate Cancer

In the last years, the use of Image Guided Stereotactic Radiotherapy (IG-SBRT) in patients with metastatic prostate cancer has increased. In this study, we aimed to assess the role of IG-SBRT in terms of local control and safety in patients with metastatic prostate cancer.

Primary and secondary endpoints of this prospective observational study were local control and safety related to IG-SBRT. All lesions were treated with 24 Gy as a single fraction or 27 Gy in 3 fractions. After SBRT, Systemic therapies were administered only after the occurrence of more than three synchronous active lesions in oligometastatic patients (patients with less than 4 active synchronous lesions) or new lesions occurrence in patients with more than 3 synchronous lesions.

From April 2011 to June 2017, 78 metastatic lesions (32 bone and 46 node) from 51 patients with prostate cancer were treated. After a median follow-up of 18.5 months (range=3-103 months), only 2 lesions (4%) relapsed inside the radiation field. All local recurrences were located on the bone. Estimated 12 and 24 months local control ratios were 98.7 and 97.4%, respectively. Except for one case, toxicity greater than G2 was not recorded.

IG-SBRT is safe and can be considered as a valid therapy in patients with metastatic prostate cancer requiring a long-lasting metastases control.

Anticancer research. 2018 May [Epub]

Francesco Pasqualetti, Marco Panichi, Aldo Sainato, Davide Baldaccini, Paola Cocuzza, Alessandra Gonnelli, Sabrina Montrone, Alessandro Molinari, Sara Barbiero, Andrea Bruschi, Elisa Notini, Stefano Ursino, Valentina Mazzotti, Riccardo Morganti, Gabriele Coraggio, Martina Cantarella, Paola Anna Erba, Fabiola Paiar

Radiation Oncology, Pisa University Hospital, Pisa, Italy ., Radiation Oncology, Pisa University Hospital, Pisa, Italy., Radiation Oncology, Casa di Cura SanRossore, Pisa, Italy., Statistical Analysis Unit, Pisa University Hospital, Pisa, Italy., Radiation Oncology, Hopitaux Universitaires Henri Mondor APHP, Créteil, France., Nuclear Medicine, Pisa University Hospital, Pisa, Italy.