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Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience

BACKGROUND: In patients presenting with limited nodal recurrence following radical prostatectomy (RP), stereotactic body radiotherapy (SBRT) results might improve with a better case selection. METHODS: Single-institution retrospective analysis of patients presenting with 1–3 lymph node (LN) recurren...

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Autores principales: Oehler, Christoph, Zimmermann, Michel, Adam, Lukas, Curschmann, Juergen, Sumila, Marcin, Strebel, Räto T., Cathomas, Richard, Li, Qiyu, Schneider, Uwe, Zwahlen, Daniel R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734440/
https://www.ncbi.nlm.nih.gov/pubmed/31500621
http://dx.doi.org/10.1186/s12894-019-0515-z
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author Oehler, Christoph
Zimmermann, Michel
Adam, Lukas
Curschmann, Juergen
Sumila, Marcin
Strebel, Räto T.
Cathomas, Richard
Li, Qiyu
Schneider, Uwe
Zwahlen, Daniel R.
author_facet Oehler, Christoph
Zimmermann, Michel
Adam, Lukas
Curschmann, Juergen
Sumila, Marcin
Strebel, Räto T.
Cathomas, Richard
Li, Qiyu
Schneider, Uwe
Zwahlen, Daniel R.
author_sort Oehler, Christoph
collection PubMed
description BACKGROUND: In patients presenting with limited nodal recurrence following radical prostatectomy (RP), stereotactic body radiotherapy (SBRT) results might improve with a better case selection. METHODS: Single-institution retrospective analysis of patients presenting with 1–3 lymph node (LN) recurrences (N1 or M1a) on 18F-Choline PET/CT. Prior therapy included radical prostatectomy (RP) ± salvage radiotherapy (RT), in absence of any systemic therapy. Outcome parameters were biochemical response (BR), time to biochemical recurrence (TBR) and time interval between SBRT and androgen deprivation therapy start (TADT). Time to event endpoints was analysed using Kaplan-Meier method. Potential prognostic factors were examined using univariate proportional hazards regression for TADT and logistic regression for BR. The optimal cut-off point for LN size was calculated using the Contal and O’Quigley method. RESULTS: 25 patients fulfilling study criteria were treated with SBRT from January 2010 to January 2015 and retrospectively analysed. Median follow up was 18 months and median LN diameter 10.5 mm. SBRT was delivered to a median dose of 36 Gy in three fractions (range: 30–45 Gy). BR was reached in 52% of cases. Median TBR was 11.9 months and significantly longer in patients with larger LN (Hazard ratio [HR] = 0.87, P = 0.03). Using 14 mm as cut off for LN, median TBR was 10.8 months for patients with small LN (18 patients), and 21.2 months for patients with large LN (6 patients) (P unadjusted = 0.009; P adjusted = 0.099). ADT was started in 32% of patients after a median follow-up of 18 months. CONCLUSIONS: For PCa patients with 1–3 LN recurrence after RP (± salvage RT), SBRT might result in a better biochemical control when delivered to larger sized (≥ 14 mm) LN metastases. This study is hypothesis generating and results should be tested in a larger prospective trial. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12894-019-0515-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-67344402019-09-12 Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience Oehler, Christoph Zimmermann, Michel Adam, Lukas Curschmann, Juergen Sumila, Marcin Strebel, Räto T. Cathomas, Richard Li, Qiyu Schneider, Uwe Zwahlen, Daniel R. BMC Urol Research Article BACKGROUND: In patients presenting with limited nodal recurrence following radical prostatectomy (RP), stereotactic body radiotherapy (SBRT) results might improve with a better case selection. METHODS: Single-institution retrospective analysis of patients presenting with 1–3 lymph node (LN) recurrences (N1 or M1a) on 18F-Choline PET/CT. Prior therapy included radical prostatectomy (RP) ± salvage radiotherapy (RT), in absence of any systemic therapy. Outcome parameters were biochemical response (BR), time to biochemical recurrence (TBR) and time interval between SBRT and androgen deprivation therapy start (TADT). Time to event endpoints was analysed using Kaplan-Meier method. Potential prognostic factors were examined using univariate proportional hazards regression for TADT and logistic regression for BR. The optimal cut-off point for LN size was calculated using the Contal and O’Quigley method. RESULTS: 25 patients fulfilling study criteria were treated with SBRT from January 2010 to January 2015 and retrospectively analysed. Median follow up was 18 months and median LN diameter 10.5 mm. SBRT was delivered to a median dose of 36 Gy in three fractions (range: 30–45 Gy). BR was reached in 52% of cases. Median TBR was 11.9 months and significantly longer in patients with larger LN (Hazard ratio [HR] = 0.87, P = 0.03). Using 14 mm as cut off for LN, median TBR was 10.8 months for patients with small LN (18 patients), and 21.2 months for patients with large LN (6 patients) (P unadjusted = 0.009; P adjusted = 0.099). ADT was started in 32% of patients after a median follow-up of 18 months. CONCLUSIONS: For PCa patients with 1–3 LN recurrence after RP (± salvage RT), SBRT might result in a better biochemical control when delivered to larger sized (≥ 14 mm) LN metastases. This study is hypothesis generating and results should be tested in a larger prospective trial. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12894-019-0515-z) contains supplementary material, which is available to authorized users. BioMed Central 2019-09-09 /pmc/articles/PMC6734440/ /pubmed/31500621 http://dx.doi.org/10.1186/s12894-019-0515-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Oehler, Christoph
Zimmermann, Michel
Adam, Lukas
Curschmann, Juergen
Sumila, Marcin
Strebel, Räto T.
Cathomas, Richard
Li, Qiyu
Schneider, Uwe
Zwahlen, Daniel R.
Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience
title Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience
title_full Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience
title_fullStr Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience
title_full_unstemmed Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience
title_short Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience
title_sort predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734440/
https://www.ncbi.nlm.nih.gov/pubmed/31500621
http://dx.doi.org/10.1186/s12894-019-0515-z
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