Stereotactic body radiotherapy for castration-sensitive prostate cancer bone oligometastases

Med Oncol. 2018 Apr 18;35(5):75. doi: 10.1007/s12032-018-1137-0.

Abstract

To evaluate outcome in patients treated with stereotactic body radiotherapy (SBRT) on bone oligometastases from castration-sensitive prostate cancer after primary treatment. We retrospectively collected data of patients with less than five lesions at time of SBRT and hormone-naïve disease at the first extra-regional localization, treated between 03/2012 and 11/2016. Prostate-specific antigen (PSA) was measured every 3 months after SBRT. Imaging was performed in case of progression. Survival analysis was performed with Kaplan-Meier (log-rank test) approach. Fifty-five patients were treated on 77 bone oligometastases. Median age, initial PSA and pre-SBRT PSA were 72 years, 9.12 and 3.5 ng/mL, respectively. Twenty-five patients (45%) received SBRT alone while the remaining 30 patients (55%) received concomitant ADT. Median follow-up was 24.6 months (range 3.0-67.2 months). No acute or late toxicity of grade > 1 was reported. Clinical progression was observed in 38 (69%) patients. 1-year biochemical progression-free survival (b-PFS), clinical progression-free survival (c-PFS), prostate-specific survival (PCSS) and local control (LC) rates were 51, 56, 100 and 83%, respectively. Comparing patients treated with SBRT alone and with concomitant ADT, no significant differences were found for those outcomes. SBRT is safe and allows high 1-year LC rate (83%) with low toxicity profile. No significant improvement in outcomes was registered with the addition of ADT to SBRT.

Keywords: Androgen deprivation therapy; Bone metastases; Castration-sensitive prostate cancer; Oligometastases; Prostate cancer; Stereotactic body radiotherapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Androgen Antagonists / administration & dosage
  • Bone Neoplasms / diagnosis
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / radiotherapy*
  • Bone Neoplasms / secondary*
  • Combined Modality Therapy
  • Humans
  • Kallikreins / blood
  • Male
  • Middle Aged
  • Orchiectomy
  • Positron Emission Tomography Computed Tomography
  • Prostate-Specific Antigen / blood
  • Prostatectomy
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / therapy*
  • Radiosurgery
  • Retrospective Studies

Substances

  • Androgen Antagonists
  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen