[Oligorecurrent prostate cancer: current management and perspectives]

Abstract

Oligometastatic prostate cancer (PCa) is an intense area of research thanks to the development of novel PET tracers such as ¹⁸F-choline or ⁶⁸Ga-PSMA. Several retrospective studies in patients with hormone-sensitive oligorecurrent PCa (usually up to 5 metastases with a controlled primary tumor) showed PSA response and a low toxicity profile of metastasis-directed therapies (MDT) such as Stereotactic Body Radiation Therapy (SBRT) or salvage lymph node dissection. More recently, randomized phase 2 studies showed that SBRT can delay the introduction of androgen deprivation, decrease biochemical relapses and increase overall survival. Regarding oligoprogressive metastatic castration-resistant PCa, limited data is however available. Based on these studies the European Association of Urology and the American Society of Radiotherapy EAU now recommend using MDT instead of observation. Several studies are undergoing in France and worldwide in order to confirm the exact role of MDT.

Keywords: Cancer de prostate; Choline PET; Oligometastatic; Oligoprogression; Oligoprogressive; Oligorecurrent; Oligorécurrence; PSMA; Radiothérapie; SBRT; TEP-FCH; oligométastatique; prostate cancer; stéréotaxique.