Local Control after Locally Ablative, Image-Guided Radiotherapy of Oligometastases Identified by Gallium-68-PSMA-Positron Emission Tomography in Castration-Sensitive Prostate Cancer Patients (OLI-P)
Progression of prostate-specific antigen (PSA) values after curative treatment of prostate cancer patients is common. Prostate-specific membrane antigen (PSMA-) PET imaging can identify patients with metachronous oligometastatic disease even at low PSA levels. Metastases-directed local ablative radi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/9/2073 |
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| author | Tobias Hölscher Michael Baumann Jörg Kotzerke Klaus Zöphel Frank Paulsen Arndt-Christian Müller Daniel Zips Christian Thomas Manfred Wirth Esther G. C. Troost Mechthild Krause Steffen Löck Fabian Lohaus |
| author_facet | Tobias Hölscher Michael Baumann Jörg Kotzerke Klaus Zöphel Frank Paulsen Arndt-Christian Müller Daniel Zips Christian Thomas Manfred Wirth Esther G. C. Troost Mechthild Krause Steffen Löck Fabian Lohaus |
| author_sort | Tobias Hölscher |
| collection | DOAJ |
| description | Progression of prostate-specific antigen (PSA) values after curative treatment of prostate cancer patients is common. Prostate-specific membrane antigen (PSMA-) PET imaging can identify patients with metachronous oligometastatic disease even at low PSA levels. Metastases-directed local ablative radiotherapy (aRT) has been shown to be a safe treatment option. In this prospective clinical trial, we evaluated local control and the pattern of tumor progression. Between 2014 and 2018, 63 patients received aRT of 89 metastases (MET) (68 lymph node (LN-)MET and 21 bony (OSS-)MET) with one of two radiation treatment schedules: 50 Gy in 2 Gy fractions in 34 MET or 30 Gy in 10 Gy fractions in 55 MET. The mean gross tumor volume and planning target volume were 2.2 and 14.9 mL, respectively. The median follow-up time was 40.7 months. Local progression occurred in seven MET, resulting in a local control rate of 93.5% after three years. Neither treatment schedule, target volume, nor type of lesion was associated with local progression. Regional progression in the proximity to the LN-MET was observed in 19 of 47 patients with at least one LN-MET (actuarial 59.3% free of regional progression after 3 years). In 33 patients (52%), a distant progression was reported. The median time to first tumor-related clinical event was 16.6 months, and 22.2% of patients had no tumor-related clinical event after three years. A total of 14 patients (22%) had another aRT. In conclusion, local ablative radiotherapy in patients with PSMA-PET staged oligometastatic prostate cancer may achieve local control, but regional or distant progression is common. Further studies are warranted, e.g., to define the optimal target volume coverage in LN-MET and OSS-MET. |
| first_indexed | 2024-03-10T04:19:27Z |
| format | Article |
| id | doaj.art-ec22eba5ba1545a78699d30831fa1dd0 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T04:19:27Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-ec22eba5ba1545a78699d30831fa1dd02023-11-23T07:54:31ZengMDPI AGCancers2072-66942022-04-01149207310.3390/cancers14092073Local Control after Locally Ablative, Image-Guided Radiotherapy of Oligometastases Identified by Gallium-68-PSMA-Positron Emission Tomography in Castration-Sensitive Prostate Cancer Patients (OLI-P)Tobias Hölscher0Michael Baumann1Jörg Kotzerke2Klaus Zöphel3Frank Paulsen4Arndt-Christian Müller5Daniel Zips6Christian Thomas7Manfred Wirth8Esther G. C. Troost9Mechthild Krause10Steffen Löck11Fabian Lohaus12Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01304 Dresden, GermanyOncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, 01307 Dresden, GermanyNational Center for Tumor Diseases (NCT), Partner Site Dresden, 01307 Dresden, GermanyDepartment of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01304 Dresden, GermanyDepartment of Radiation Oncology, Medical Faculty and University Hospital Tübingen, 72001 Tübingen, GermanyDepartment of Radiation Oncology, Medical Faculty and University Hospital Tübingen, 72001 Tübingen, GermanyDepartment of Radiation Oncology, Medical Faculty and University Hospital Tübingen, 72001 Tübingen, GermanyNational Center for Tumor Diseases (NCT), Partner Site Dresden, 01307 Dresden, GermanyDepartment of Urology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01304 Dresden, GermanyDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01304 Dresden, GermanyDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01304 Dresden, GermanyDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01304 Dresden, GermanyDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01304 Dresden, GermanyProgression of prostate-specific antigen (PSA) values after curative treatment of prostate cancer patients is common. Prostate-specific membrane antigen (PSMA-) PET imaging can identify patients with metachronous oligometastatic disease even at low PSA levels. Metastases-directed local ablative radiotherapy (aRT) has been shown to be a safe treatment option. In this prospective clinical trial, we evaluated local control and the pattern of tumor progression. Between 2014 and 2018, 63 patients received aRT of 89 metastases (MET) (68 lymph node (LN-)MET and 21 bony (OSS-)MET) with one of two radiation treatment schedules: 50 Gy in 2 Gy fractions in 34 MET or 30 Gy in 10 Gy fractions in 55 MET. The mean gross tumor volume and planning target volume were 2.2 and 14.9 mL, respectively. The median follow-up time was 40.7 months. Local progression occurred in seven MET, resulting in a local control rate of 93.5% after three years. Neither treatment schedule, target volume, nor type of lesion was associated with local progression. Regional progression in the proximity to the LN-MET was observed in 19 of 47 patients with at least one LN-MET (actuarial 59.3% free of regional progression after 3 years). In 33 patients (52%), a distant progression was reported. The median time to first tumor-related clinical event was 16.6 months, and 22.2% of patients had no tumor-related clinical event after three years. A total of 14 patients (22%) had another aRT. In conclusion, local ablative radiotherapy in patients with PSMA-PET staged oligometastatic prostate cancer may achieve local control, but regional or distant progression is common. Further studies are warranted, e.g., to define the optimal target volume coverage in LN-MET and OSS-MET.https://www.mdpi.com/2072-6694/14/9/2073prostatic neoplasmsprospective studiesradiotherapyimage-guidedradiosurgerypositron emission tomography |
| spellingShingle | Tobias Hölscher Michael Baumann Jörg Kotzerke Klaus Zöphel Frank Paulsen Arndt-Christian Müller Daniel Zips Christian Thomas Manfred Wirth Esther G. C. Troost Mechthild Krause Steffen Löck Fabian Lohaus Local Control after Locally Ablative, Image-Guided Radiotherapy of Oligometastases Identified by Gallium-68-PSMA-Positron Emission Tomography in Castration-Sensitive Prostate Cancer Patients (OLI-P) Cancers prostatic neoplasms prospective studies radiotherapy image-guided radiosurgery positron emission tomography |
| title | Local Control after Locally Ablative, Image-Guided Radiotherapy of Oligometastases Identified by Gallium-68-PSMA-Positron Emission Tomography in Castration-Sensitive Prostate Cancer Patients (OLI-P) |
| title_full | Local Control after Locally Ablative, Image-Guided Radiotherapy of Oligometastases Identified by Gallium-68-PSMA-Positron Emission Tomography in Castration-Sensitive Prostate Cancer Patients (OLI-P) |
| title_fullStr | Local Control after Locally Ablative, Image-Guided Radiotherapy of Oligometastases Identified by Gallium-68-PSMA-Positron Emission Tomography in Castration-Sensitive Prostate Cancer Patients (OLI-P) |
| title_full_unstemmed | Local Control after Locally Ablative, Image-Guided Radiotherapy of Oligometastases Identified by Gallium-68-PSMA-Positron Emission Tomography in Castration-Sensitive Prostate Cancer Patients (OLI-P) |
| title_short | Local Control after Locally Ablative, Image-Guided Radiotherapy of Oligometastases Identified by Gallium-68-PSMA-Positron Emission Tomography in Castration-Sensitive Prostate Cancer Patients (OLI-P) |
| title_sort | local control after locally ablative image guided radiotherapy of oligometastases identified by gallium 68 psma positron emission tomography in castration sensitive prostate cancer patients oli p |
| topic | prostatic neoplasms prospective studies radiotherapy image-guided radiosurgery positron emission tomography |
| url | https://www.mdpi.com/2072-6694/14/9/2073 |
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