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Systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer
PURPOSE: To evaluate the oncological outcome after stereotactic body radiation therapy (SBRT) for oligometastatic hormone-sensitive prostate cancer (omHSPC) patients. MATERIALS-METHODS: In this retrospective, observational, multi-institutional study, omHSPC patients (≤5 metastases) underwent SBRT. P...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493250/ https://www.ncbi.nlm.nih.gov/pubmed/37701481 http://dx.doi.org/10.1016/j.ctro.2023.100673 |
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author | Baron, D. Pasquier, D. Pace-Loscos, T. Vandendorpe, B Schiappa, R. Ortholan, C. Hannoun-Levi, J.M. |
author_facet | Baron, D. Pasquier, D. Pace-Loscos, T. Vandendorpe, B Schiappa, R. Ortholan, C. Hannoun-Levi, J.M. |
author_sort | Baron, D. |
collection | PubMed |
description | PURPOSE: To evaluate the oncological outcome after stereotactic body radiation therapy (SBRT) for oligometastatic hormone-sensitive prostate cancer (omHSPC) patients. MATERIALS-METHODS: In this retrospective, observational, multi-institutional study, omHSPC patients (≤5 metastases) underwent SBRT. Primary endpoint was systemic therapy escalation-free survival (STE-FS) after SBRT. Local (LR), distant (DR), prostatic (PR) and isolated biochemical (iBR) relapses were reported with progression-free survival (PFS) and overall survival (OS). Prognostic factors for STE-FS were investigated. Toxicity was reported. RESULTS: From 01/07 to 09/19, 119 pts with omHSPC underwent SBRT. With a MFU of 34 months [12–97], median STE-FS was 33.4 months (95%CI 26.6–––40.1). Median OS was not reached and PFS was 22.7 months (CI95% 18.6–––32.3). Post-SBRT-PSA remained stable or decreased in 87 pts (73.1%). Progression events (LR, MR, PR, iBR) were observed in 72 pts (60.5%), among whom 6 relapsed in the irradiated area (local control rate: 95%). DR, BR, PR were observed in 44 pts (37%), 21pts (17.7%) and 2 pts (1.7%) respectively. In multivariate analysis, post-SBRT biochemical response was an independent prognostic factor for STE-FS. Grade ≥ 3 toxicity occurred in 1pt. CONCLUSION: With excellent local control and tolerance, SBRT for omHSPC patients represents an attractive approach to defer systemic therapeutic escalation and prevent its side effects. Accurate patient selection for SBRT requires more data with longer follow-up and higher numbers of patients pending the results of upcoming randomized trials. |
format | Online Article Text |
id | pubmed-10493250 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-104932502023-09-12 Systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer Baron, D. Pasquier, D. Pace-Loscos, T. Vandendorpe, B Schiappa, R. Ortholan, C. Hannoun-Levi, J.M. Clin Transl Radiat Oncol Original Research Article PURPOSE: To evaluate the oncological outcome after stereotactic body radiation therapy (SBRT) for oligometastatic hormone-sensitive prostate cancer (omHSPC) patients. MATERIALS-METHODS: In this retrospective, observational, multi-institutional study, omHSPC patients (≤5 metastases) underwent SBRT. Primary endpoint was systemic therapy escalation-free survival (STE-FS) after SBRT. Local (LR), distant (DR), prostatic (PR) and isolated biochemical (iBR) relapses were reported with progression-free survival (PFS) and overall survival (OS). Prognostic factors for STE-FS were investigated. Toxicity was reported. RESULTS: From 01/07 to 09/19, 119 pts with omHSPC underwent SBRT. With a MFU of 34 months [12–97], median STE-FS was 33.4 months (95%CI 26.6–––40.1). Median OS was not reached and PFS was 22.7 months (CI95% 18.6–––32.3). Post-SBRT-PSA remained stable or decreased in 87 pts (73.1%). Progression events (LR, MR, PR, iBR) were observed in 72 pts (60.5%), among whom 6 relapsed in the irradiated area (local control rate: 95%). DR, BR, PR were observed in 44 pts (37%), 21pts (17.7%) and 2 pts (1.7%) respectively. In multivariate analysis, post-SBRT biochemical response was an independent prognostic factor for STE-FS. Grade ≥ 3 toxicity occurred in 1pt. CONCLUSION: With excellent local control and tolerance, SBRT for omHSPC patients represents an attractive approach to defer systemic therapeutic escalation and prevent its side effects. Accurate patient selection for SBRT requires more data with longer follow-up and higher numbers of patients pending the results of upcoming randomized trials. Elsevier 2023-08-31 /pmc/articles/PMC10493250/ /pubmed/37701481 http://dx.doi.org/10.1016/j.ctro.2023.100673 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Article Baron, D. Pasquier, D. Pace-Loscos, T. Vandendorpe, B Schiappa, R. Ortholan, C. Hannoun-Levi, J.M. Systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer |
title | Systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer |
title_full | Systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer |
title_fullStr | Systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer |
title_full_unstemmed | Systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer |
title_short | Systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer |
title_sort | systemic therapy escalation after stereotactic body radiation therapy for oligometastatic hormone-sensitive prostate cancer |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493250/ https://www.ncbi.nlm.nih.gov/pubmed/37701481 http://dx.doi.org/10.1016/j.ctro.2023.100673 |
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