Androgen Receptor Targeted Therapy + Radiotherapy in Metastatic Castration Resistant Prostate Cancer
ObjectivesTo investigate whether radiotherapy as metastasis-directed therapy (MDT) on oligo-progressive sites in metastatic castration-resistant prostate cancer (mCRPC) patients during treatment with androgen receptor-targeted therapy (ARTT) may lead to control resistant lesions, prolonging ARTT. We...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.695136/full |
| _version_ | 1818908531450970112 |
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| author | Maria Massaro Giuseppe Facondo Gianluca Vullo Anna Maria Aschelter Alessandro Rossi Vitaliana De Sanctis Paolo Marchetti Mattia Falchetto Osti Maurizio Valeriani |
| author_facet | Maria Massaro Giuseppe Facondo Gianluca Vullo Anna Maria Aschelter Alessandro Rossi Vitaliana De Sanctis Paolo Marchetti Mattia Falchetto Osti Maurizio Valeriani |
| author_sort | Maria Massaro |
| collection | DOAJ |
| description | ObjectivesTo investigate whether radiotherapy as metastasis-directed therapy (MDT) on oligo-progressive sites in metastatic castration-resistant prostate cancer (mCRPC) patients during treatment with androgen receptor-targeted therapy (ARTT) may lead to control resistant lesions, prolonging ARTT. We analysed progression free survival, overall survival and prognostic parameters that can identify patients that best suit to this approach.Patients and MethodsRetrospective analysis of a total of 67 lesions in 42 mCRPC patients treated with ablative or palliative RT to oligoprogressive lesions during ARTT. Twenty-eight patients (67%) underwent ARTT with Abiraterone acetate and 14 patients (33%) underwent ARTT with Enzalutamide. Median time between the start of ADT and ARTT beginning was 50.14 months (range 3.37-219 months). We treated 58 lesions (87%) with 3D conformal radiotherapy (3DCRT) and nine lesions (13%) with stereotactic body radiotherapy (SBRT). The Kaplan Meier method was used to assess the median overall survival (OS) and the progression-free survival (PFS).ResultsMedian follow-up was 28 months (range 3-82 months). Median OS was 32.5 months (95% CI 25.77-39.16), 1 and 2-year OS were 71.6% and 64.1%, respectively. Median PFS was 19,8 months (95% CI 11.34–28.31), 1 and 2-year PFS were 67.2% and 47.4%, respectively. Median OS for patients that underwent radiotherapy before 6 months from the start of ARTT was 23.4 months (95% CI 2.04-44.89) and 45.5 months (95% CI 31.19-59.8) for patients that underwent radiotherapy after 6 months (p = 0.009).ConclusionLocal ablative radiation therapy directed to progressive metastasis is a non-invasive, well tolerated treatment with efficacy on prolonging clinical benefit of systemic therapies with ARTT. Patients who underwent RT >6 months from the start of ARTT presented a statistically better OS and PFS compared with patients who underwent radiotherapy <6 months from the start of ARTT. |
| first_indexed | 2024-12-19T22:12:30Z |
| format | Article |
| id | doaj.art-3089c05139fa4368942c6c3e1dcda5cb |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-19T22:12:30Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-3089c05139fa4368942c6c3e1dcda5cb2022-12-21T20:03:51ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-09-011110.3389/fonc.2021.695136695136Androgen Receptor Targeted Therapy + Radiotherapy in Metastatic Castration Resistant Prostate CancerMaria Massaro0Giuseppe Facondo1Gianluca Vullo2Anna Maria Aschelter3Alessandro Rossi4Vitaliana De Sanctis5Paolo Marchetti6Mattia Falchetto Osti7Maurizio Valeriani8Department of Radiation Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyDepartment of Radiation Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyDepartment of Radiation Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyDepartment of Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyDepartment of Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyDepartment of Radiation Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyDepartment of Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyDepartment of Radiation Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyDepartment of Radiation Oncology, “Sapienza” University, Sant’Andrea Hospital, Rome, ItalyObjectivesTo investigate whether radiotherapy as metastasis-directed therapy (MDT) on oligo-progressive sites in metastatic castration-resistant prostate cancer (mCRPC) patients during treatment with androgen receptor-targeted therapy (ARTT) may lead to control resistant lesions, prolonging ARTT. We analysed progression free survival, overall survival and prognostic parameters that can identify patients that best suit to this approach.Patients and MethodsRetrospective analysis of a total of 67 lesions in 42 mCRPC patients treated with ablative or palliative RT to oligoprogressive lesions during ARTT. Twenty-eight patients (67%) underwent ARTT with Abiraterone acetate and 14 patients (33%) underwent ARTT with Enzalutamide. Median time between the start of ADT and ARTT beginning was 50.14 months (range 3.37-219 months). We treated 58 lesions (87%) with 3D conformal radiotherapy (3DCRT) and nine lesions (13%) with stereotactic body radiotherapy (SBRT). The Kaplan Meier method was used to assess the median overall survival (OS) and the progression-free survival (PFS).ResultsMedian follow-up was 28 months (range 3-82 months). Median OS was 32.5 months (95% CI 25.77-39.16), 1 and 2-year OS were 71.6% and 64.1%, respectively. Median PFS was 19,8 months (95% CI 11.34–28.31), 1 and 2-year PFS were 67.2% and 47.4%, respectively. Median OS for patients that underwent radiotherapy before 6 months from the start of ARTT was 23.4 months (95% CI 2.04-44.89) and 45.5 months (95% CI 31.19-59.8) for patients that underwent radiotherapy after 6 months (p = 0.009).ConclusionLocal ablative radiation therapy directed to progressive metastasis is a non-invasive, well tolerated treatment with efficacy on prolonging clinical benefit of systemic therapies with ARTT. Patients who underwent RT >6 months from the start of ARTT presented a statistically better OS and PFS compared with patients who underwent radiotherapy <6 months from the start of ARTT.https://www.frontiersin.org/articles/10.3389/fonc.2021.695136/fulloligo-progressive castration-resistant prostate cancerandrogen receptor targeted therapymetastasis-directed radiation therapyconformal radiotherapystereotactic body radiotherapy (SBRT) |
| spellingShingle | Maria Massaro Giuseppe Facondo Gianluca Vullo Anna Maria Aschelter Alessandro Rossi Vitaliana De Sanctis Paolo Marchetti Mattia Falchetto Osti Maurizio Valeriani Androgen Receptor Targeted Therapy + Radiotherapy in Metastatic Castration Resistant Prostate Cancer Frontiers in Oncology oligo-progressive castration-resistant prostate cancer androgen receptor targeted therapy metastasis-directed radiation therapy conformal radiotherapy stereotactic body radiotherapy (SBRT) |
| title | Androgen Receptor Targeted Therapy + Radiotherapy in Metastatic Castration Resistant Prostate Cancer |
| title_full | Androgen Receptor Targeted Therapy + Radiotherapy in Metastatic Castration Resistant Prostate Cancer |
| title_fullStr | Androgen Receptor Targeted Therapy + Radiotherapy in Metastatic Castration Resistant Prostate Cancer |
| title_full_unstemmed | Androgen Receptor Targeted Therapy + Radiotherapy in Metastatic Castration Resistant Prostate Cancer |
| title_short | Androgen Receptor Targeted Therapy + Radiotherapy in Metastatic Castration Resistant Prostate Cancer |
| title_sort | androgen receptor targeted therapy radiotherapy in metastatic castration resistant prostate cancer |
| topic | oligo-progressive castration-resistant prostate cancer androgen receptor targeted therapy metastasis-directed radiation therapy conformal radiotherapy stereotactic body radiotherapy (SBRT) |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.695136/full |
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