The literature on metastasis-directed therapy for oligometastatic prostate cancer (PCa) recurrence consists of small heterogeneous studies. This study aimed to reduce the heterogeneity by pooling individual patient data from different institutions treating oligometastatic PCa recurrence with stereotactic body radiotherapy (SBRT).
We focussed on patients who were treatment naive, with the aim of determining if SBRT could delay disease progression. We included patients with three or fewer metastases. The Kaplan-Meier method was used to estimate distant progression-free survival (DPFS) and local progression-free survival (LPFS). Toxicity was scored using the Common Terminology Criteria for Adverse Events. In total, 163 metastases were treated in 119 patients. The median DPFS was 21 mo (95% confidence interval, 15-26 mo). A lower radiotherapy dose predicted a higher local recurrence rate with a 3-yr LPFS of 79% for patients treated with a biologically effective dose ≤100Gy versus 99% for patients treated with >100Gy (p=0. 01). Seventeen patients (14%) developed toxicity classified as grade 1, and three patients (3%) developed grade 2 toxicity. No grade ≥3 toxicity occurred. These results should serve as a benchmark for future prospective trials.
This multi-institutional study pools all of the available data on the use of stereotactic body radiotherapy for limited prostate cancer metastases. We concluded that this approach is safe and associated with a prolonged treatment progression-free survival.
European urology. 2015 Jul 16 [Epub ahead of print]
Piet Ost, Barbara Alicja Jereczek-Fossa, Nicholas Van As, Thomas Zilli, Alexander Muacevic, Kenneth Olivier, Daniel Henderson, Franco Casamassima, Roberto Orecchia, Alessia Surgo, Lindsay Brown, Alison Tree, Raymond Miralbell, Gert De Meerleer
Department of Radiotherapy, Ghent University Hospital, Belgium. University of Milan and European Institute of Oncology, Milan Italy. , Department of Radiotherapy Royal Marsden NHS Foundation Trust, London, UK. , Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland. , Cyberknife Center Munich Grosshadern, Munich, Germany. , Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA. , Department of Radiotherapy Royal Marsden NHS Foundation Trust, London, UK. , Ecomedica Radioterapia, Empoli, Italy. , University of Milan and European Institute of Oncology, Milan Italy. , University of Milan and European Institute of Oncology, Milan Italy. , Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA. , Department of Radiotherapy Royal Marsden NHS Foundation Trust, London, UK. , Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland. , Department of Radiotherapy, Ghent University Hospital, Belgium.