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1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer

Introduction: The aim of our study was to evaluate the efficacy and toxicity of a daily adaptive MR-guided SBRT on 1.5 T MR-linac in patients affected by lymph node oligometastases from PCa. Materials and Methods: The present study is a prospective observational study conducted in a single instituti...

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Autores principales: Nicosia, Luca, Trapani, Giovanna, Rigo, Michele, Giaj-Levra, Niccolò, Mazzola, Rosario, Pastorello, Edoardo, Ricchetti, Francesco, Cuccia, Francesco, Figlia, Vanessa, Fiorini, Matilde, Alongi, Filippo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697920/
https://www.ncbi.nlm.nih.gov/pubmed/36431135
http://dx.doi.org/10.3390/jcm11226658
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author Nicosia, Luca
Trapani, Giovanna
Rigo, Michele
Giaj-Levra, Niccolò
Mazzola, Rosario
Pastorello, Edoardo
Ricchetti, Francesco
Cuccia, Francesco
Figlia, Vanessa
Fiorini, Matilde
Alongi, Filippo
author_facet Nicosia, Luca
Trapani, Giovanna
Rigo, Michele
Giaj-Levra, Niccolò
Mazzola, Rosario
Pastorello, Edoardo
Ricchetti, Francesco
Cuccia, Francesco
Figlia, Vanessa
Fiorini, Matilde
Alongi, Filippo
author_sort Nicosia, Luca
collection PubMed
description Introduction: The aim of our study was to evaluate the efficacy and toxicity of a daily adaptive MR-guided SBRT on 1.5 T MR-linac in patients affected by lymph node oligometastases from PCa. Materials and Methods: The present study is a prospective observational study conducted in a single institution (protocol n°: MRI/LINAC n. 23748). Patients with oligometastatic lymph nodes from PCa treated with daily adaptive MR-guided SBRT on 1.5 T MR-linac were included in the study. There was a minimum required follow-up of 3 months after SBRT. The primary end-point was local progression-free survival (LPFS). The secondary end-points were: nodal progression-free survival (NPFS), progression-free survival (PFS), and toxicity. Results: A total of 118 lymph node oligometastases from PCa were treated with daily adaptive 1.5 T MR-guided SBRT in 63 oligometastatic patients. Of the patients, 63.5% were oligorecurrent and 36.5% were oligoprogressive. The two-year LPFS was 90.7%. The median NPFS was 22.3 months and the 2-year NPFS was 46.5%. Receiving hormone therapy before SBRT was correlated with a lower NPFS at the multivariate analysis (1 y NPFS 87.1% versus 42.8%; p = 0.002–HR 0.199, 95% CI 0.073–0.549). Furthermore, the oligorecurrent state during ADT was correlated with a lower NPFS than was the oligoprogressive state. The median PFS was 10.3 months and the 2-year PFS was 32.4%. Patients treated with hormone therapy before SBRT had a significantly lower 1-year PFS the others (28% versus 70.4%; p = 0.01–HR 0.259, 95% CI 0.117–0.574). No acute and late toxicities occurred during treatment. Conclusions: The present study is the largest prospective study of 1.5 T lymph node SBRT on MR-linac in patients with PCa. Lymph node SBRT by 1.5 T MR-linac provides high local control rates with an excellent toxicity profile.
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spelling pubmed-96979202022-11-26 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer Nicosia, Luca Trapani, Giovanna Rigo, Michele Giaj-Levra, Niccolò Mazzola, Rosario Pastorello, Edoardo Ricchetti, Francesco Cuccia, Francesco Figlia, Vanessa Fiorini, Matilde Alongi, Filippo J Clin Med Article Introduction: The aim of our study was to evaluate the efficacy and toxicity of a daily adaptive MR-guided SBRT on 1.5 T MR-linac in patients affected by lymph node oligometastases from PCa. Materials and Methods: The present study is a prospective observational study conducted in a single institution (protocol n°: MRI/LINAC n. 23748). Patients with oligometastatic lymph nodes from PCa treated with daily adaptive MR-guided SBRT on 1.5 T MR-linac were included in the study. There was a minimum required follow-up of 3 months after SBRT. The primary end-point was local progression-free survival (LPFS). The secondary end-points were: nodal progression-free survival (NPFS), progression-free survival (PFS), and toxicity. Results: A total of 118 lymph node oligometastases from PCa were treated with daily adaptive 1.5 T MR-guided SBRT in 63 oligometastatic patients. Of the patients, 63.5% were oligorecurrent and 36.5% were oligoprogressive. The two-year LPFS was 90.7%. The median NPFS was 22.3 months and the 2-year NPFS was 46.5%. Receiving hormone therapy before SBRT was correlated with a lower NPFS at the multivariate analysis (1 y NPFS 87.1% versus 42.8%; p = 0.002–HR 0.199, 95% CI 0.073–0.549). Furthermore, the oligorecurrent state during ADT was correlated with a lower NPFS than was the oligoprogressive state. The median PFS was 10.3 months and the 2-year PFS was 32.4%. Patients treated with hormone therapy before SBRT had a significantly lower 1-year PFS the others (28% versus 70.4%; p = 0.01–HR 0.259, 95% CI 0.117–0.574). No acute and late toxicities occurred during treatment. Conclusions: The present study is the largest prospective study of 1.5 T lymph node SBRT on MR-linac in patients with PCa. Lymph node SBRT by 1.5 T MR-linac provides high local control rates with an excellent toxicity profile. MDPI 2022-11-10 /pmc/articles/PMC9697920/ /pubmed/36431135 http://dx.doi.org/10.3390/jcm11226658 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nicosia, Luca
Trapani, Giovanna
Rigo, Michele
Giaj-Levra, Niccolò
Mazzola, Rosario
Pastorello, Edoardo
Ricchetti, Francesco
Cuccia, Francesco
Figlia, Vanessa
Fiorini, Matilde
Alongi, Filippo
1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer
title 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer
title_full 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer
title_fullStr 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer
title_full_unstemmed 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer
title_short 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer
title_sort 1.5 t mr-guided daily adapted sbrt on lymph node oligometastases from prostate cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697920/
https://www.ncbi.nlm.nih.gov/pubmed/36431135
http://dx.doi.org/10.3390/jcm11226658
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