Androgen deprivation therapy (ADT) is a mainstay of treatment for metastatic prostate cancer, while additional salvage radiotherapy may offer prolonged remission for patients with regional node relapses. We report 5-yr outcomes from OLIGOPELVIS (GETUG-P07), an open-label phase 2 trial assessing long-term outcomes and patterns of relapse after 6-mo ADT and elective nodal radiotherapy (ENRT) in men with pelvic nodal oligorecurrence (<6 lesions) of prostate cancer. Progression was defined as two consecutive prostate-specific antigen (PSA) levels above the level at inclusion and/or clinical progression according to Response Evaluation Criteria in Solid Tumors v1.1 and/or death from any cause. Sixty-seven patients were recruited. Median follow-up was 6.1 yr (95% confidence interval 5.9-6.3). Rates of grade 2+ toxicities among patients without progression at 3, 4, and 5 yr were 15%, 9%, and 4% for genitourinary toxicities, and 2%, 3%, and 4% for gastrointestinal toxicities, respectively. The 5-yr progression-free, biochemical relapse-free, and ADT-free survival rates were 39%, 31%, and 64%, respectively. In total, 45 patients experienced progression, which was PSA-only progression in seven cases. Among the other 38 patients, local clinical progression occurred in 18%, progression to N1 stage in 29%, to M1a stage in 50%, to M1b stage in 32%, and to M1c stage in 11%. Finally, combined ENRT and ADT appeared to prolong tumor control with limited toxicity. At 5 yr, one-third of the patients had not experienced biochemical relapse. The major site of relapse was the para-aortic lymph nodes. PATIENT SUMMARY: We evaluated long-term results for high-dose radiotherapy in patients with recurrence of prostate cancer in pelvic lymph nodes. We found that this treatment provided prolonged tumor control without significant toxicity. One-third of the patients were still in complete remission after 5 years.
European urology. 2024 Mar 14 [Epub ahead of print]
Loig Vaugier, Cyrille Morvan, David Pasquier, Xavier Buthaud, Nicolas Magné, Veronique Beckendorf, Paul Sargos, Gilles Crehange, Pascal Pommier, Genevieve Loos, Ali Hasbini, Igor Latorzeff, Marlon Silva, Julie Paul, Audrey Blanc-Lapierre, Stéphane Supiot
Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Saint-Herblain, France., Department of Nuclear Medicine, Institut de Cancérologie de l'Ouest, Saint-Herblain, France., Academic Radiation Oncology Department, Centre Oscar Lambret, Lille, France; Centre de Recherche en Informatique, Signal et Automatique de Lille, CRIStAL UMR CNRS 9189, Université de Lille, Lille, France., Department of Radiation Oncology, Centre Catherine de Sienne, Nantes, France., Department of Radiation Oncology, Institut de Cancérologie de la Loire, St. Priest en Jarez, France., Department of Radiation Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy, France., Department of Radiation Oncology, Institut Bergonié, Bordeaux, France., Department of Radiation Oncology, Georges-Francois Leclerc Cancer Center, Dijon, France., Department of Radiation Oncology, Centre Léon Bérard, Lyon, France., Department of Radiation Oncology, Centre Jean Perrin, Clermont-Ferrand, France., Department of Radiation Oncology, Clinique Pasteur, Brest, France., Department of Radiation Oncology, Oncorad Clinique Pasteur, Toulouse, France., Department of Radiation Oncology, Centre Francois Baclesse, Caen, France., Department of Biostatistics, Institut de Cancérologie de l'Ouest, Saint-Herblain, France., Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Saint-Herblain, France; Laboratoire US2B, Unité en Sciences Biologiques et Biotechnologies, UMR CNRS 6286, UFR Sciences et Techniques, Nantes, France. Electronic address: .