Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience
<i>Background:</i> The favorable role of SBRT for lymph-nodal oligometastases from prostate cancer has been reported by several retrospective and prospective experiences, suggesting a more indolent natural history of disease when compared to patients with bone oligometastases. This retro...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
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MDPI AG
2023-08-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/8/1442 |
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| author | Francesco Cuccia Maria Tamburo Antonio Piras Gianluca Mortellaro Arianna Iudica Antonino Daidone Manuela Federico Valentina Zagardo Gianluca Ferini Francesco Marletta Corrado Spatola Ivan Fazio Sergio Filosto Stefano Pergolizzi Giuseppe Ferrera |
| author_facet | Francesco Cuccia Maria Tamburo Antonio Piras Gianluca Mortellaro Arianna Iudica Antonino Daidone Manuela Federico Valentina Zagardo Gianluca Ferini Francesco Marletta Corrado Spatola Ivan Fazio Sergio Filosto Stefano Pergolizzi Giuseppe Ferrera |
| author_sort | Francesco Cuccia |
| collection | DOAJ |
| description | <i>Background:</i> The favorable role of SBRT for lymph-nodal oligometastases from prostate cancer has been reported by several retrospective and prospective experiences, suggesting a more indolent natural history of disease when compared to patients with bone oligometastases. This retrospective multicenter study evaluates the outcomes of a cohort of patients treated with stereotactic body radiotherapy for lymph-nodal oligometastases. <i>Methods:</i> Inclusion criteria were up to five lymph-nodal oligometastases detected either with Choline-PET or PSMA-PET in patients naïve for ADT or already ongoing with systemic therapy and at least 6 Gy per fraction for SBRT. Only patients with exclusive lymph-nodal disease were included. The primary endpoint of the study was LC; a toxicity assessment was retrospectively performed following CTCAE v4.0. <i>Results:</i> A total of 100 lymph-nodal oligometastases in 69 patients have been treated with SBRT between April 2015 and November 2022. The median age was 73 years (range, 60–85). Oligometastatic disease was mainly detected with Choline-PET in 47 cases, while the remaining were diagnosed using PSMA-PET, with most of the patients treated to a single lymph-nodal metastasis (48/69 cases), two in 14 cases, and three in the remaining cases. The median PSA prior to SBRT was 1.35 ng/mL (range, 0.3–23.7 ng/mL). Patients received SBRT with a median total dose of 35 Gy (range, 30–40 Gy) in a median number of 5 (range, 3–6) fractions. With a median follow-up of 16 months (range, 7–59 months), our LC rates were 95.8% and 86.3% at 1 and 2 years. DPFS rates were 90.4% and 53.4%, respectively, at 1 and 2 years, with nine patients developing a sequential oligometastatic disease treated with a second course of SBRT. Polymetastatic disease-free survival (PMFS) at 1 and 2 years was 98% and 96%. Six patients needed ADT after SBRT for a median time of ADT-free survival of 15 months (range, 6–22 months). The median OS was 16 months (range, 7–59) with 1- and 2-year rates of both 98%. In multivariate analysis, higher LC rates and the use of PSMA-PET were related to improved DPFS rates, and OS was significantly related to a lower incidence of distant progression. No G3 or higher adverse events were reported. <i>Conclusions:</i> In our experience, lymph-nodal SBRT for oligometastatic prostate cancer is a safe and effective option for ADT delay with no severe toxicity. |
| first_indexed | 2024-03-10T23:45:40Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T23:45:40Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-7b616ba4e9534f448febce8f42709a622023-11-19T02:06:21ZengMDPI AGMedicina1010-660X1648-91442023-08-01598144210.3390/medicina59081442Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective ExperienceFrancesco Cuccia0Maria Tamburo1Antonio Piras2Gianluca Mortellaro3Arianna Iudica4Antonino Daidone5Manuela Federico6Valentina Zagardo7Gianluca Ferini8Francesco Marletta9Corrado Spatola10Ivan Fazio11Sergio Filosto12Stefano Pergolizzi13Giuseppe Ferrera14Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, ItalyRadiotherapy Unit, Cannizzaro Hospital, 95100 Catania, ItalyRadioterapia Oncologica, Villa Santa Teresa, 90100 Palermo, ItalyRadiation Oncology, ARNAS Civico Hospital, 90100 Palermo, ItalyRadiotherapy Unit, AOU Policlinico-VE, 95100 Catania, ItalyRadioterapia Oncologica, Villa Santa Teresa, 90100 Palermo, ItalyRadiotherapy Unit, Casa di Cura Macchiarella, 90100 Palermo, ItalyRadiation Oncology Unit, REM Radioterapia, 95100 Viagrande, CT, ItalyRadiation Oncology Unit, REM Radioterapia, 95100 Viagrande, CT, ItalyRadiotherapy Unit, Cannizzaro Hospital, 95100 Catania, ItalyRadiotherapy Unit, AOU Policlinico-VE, 95100 Catania, ItalyRadiotherapy Unit, Casa di Cura Macchiarella, 90100 Palermo, ItalyRadiation Oncology Unit, La Maddalena Dipartimento Oncologico di III Livello, 90100 Palermo, ItalyDepartment of Radiological Science, University of Messina, 98121 Messina, ItalyRadiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy<i>Background:</i> The favorable role of SBRT for lymph-nodal oligometastases from prostate cancer has been reported by several retrospective and prospective experiences, suggesting a more indolent natural history of disease when compared to patients with bone oligometastases. This retrospective multicenter study evaluates the outcomes of a cohort of patients treated with stereotactic body radiotherapy for lymph-nodal oligometastases. <i>Methods:</i> Inclusion criteria were up to five lymph-nodal oligometastases detected either with Choline-PET or PSMA-PET in patients naïve for ADT or already ongoing with systemic therapy and at least 6 Gy per fraction for SBRT. Only patients with exclusive lymph-nodal disease were included. The primary endpoint of the study was LC; a toxicity assessment was retrospectively performed following CTCAE v4.0. <i>Results:</i> A total of 100 lymph-nodal oligometastases in 69 patients have been treated with SBRT between April 2015 and November 2022. The median age was 73 years (range, 60–85). Oligometastatic disease was mainly detected with Choline-PET in 47 cases, while the remaining were diagnosed using PSMA-PET, with most of the patients treated to a single lymph-nodal metastasis (48/69 cases), two in 14 cases, and three in the remaining cases. The median PSA prior to SBRT was 1.35 ng/mL (range, 0.3–23.7 ng/mL). Patients received SBRT with a median total dose of 35 Gy (range, 30–40 Gy) in a median number of 5 (range, 3–6) fractions. With a median follow-up of 16 months (range, 7–59 months), our LC rates were 95.8% and 86.3% at 1 and 2 years. DPFS rates were 90.4% and 53.4%, respectively, at 1 and 2 years, with nine patients developing a sequential oligometastatic disease treated with a second course of SBRT. Polymetastatic disease-free survival (PMFS) at 1 and 2 years was 98% and 96%. Six patients needed ADT after SBRT for a median time of ADT-free survival of 15 months (range, 6–22 months). The median OS was 16 months (range, 7–59) with 1- and 2-year rates of both 98%. In multivariate analysis, higher LC rates and the use of PSMA-PET were related to improved DPFS rates, and OS was significantly related to a lower incidence of distant progression. No G3 or higher adverse events were reported. <i>Conclusions:</i> In our experience, lymph-nodal SBRT for oligometastatic prostate cancer is a safe and effective option for ADT delay with no severe toxicity.https://www.mdpi.com/1648-9144/59/8/1442stereotactic radiotherapyoligometastaseslymphnodesprostate cancer |
| spellingShingle | Francesco Cuccia Maria Tamburo Antonio Piras Gianluca Mortellaro Arianna Iudica Antonino Daidone Manuela Federico Valentina Zagardo Gianluca Ferini Francesco Marletta Corrado Spatola Ivan Fazio Sergio Filosto Stefano Pergolizzi Giuseppe Ferrera Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience Medicina stereotactic radiotherapy oligometastases lymphnodes prostate cancer |
| title | Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience |
| title_full | Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience |
| title_fullStr | Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience |
| title_full_unstemmed | Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience |
| title_short | Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience |
| title_sort | stereotactic body radiotherapy for lymph nodal oligometastatic prostate cancer a multicenter retrospective experience |
| topic | stereotactic radiotherapy oligometastases lymphnodes prostate cancer |
| url | https://www.mdpi.com/1648-9144/59/8/1442 |
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