TY - JOUR
T1 - Stereotactic ablative radiation therapy for oligometastatic prostate cancer delays time-to-next systemic treatment
AU - Moyer, C. Leigh
AU - Phillips, Ryan
AU - Deek, Matthew P.
AU - Radwan, Noura
AU - Ross, Ashley E.
AU - Antonarakis, Emmanuel S.
AU - Reyes, Diane
AU - Wright, Jean
AU - Terezakis, Stephanie A.
AU - Song, Daniel Y.
AU - DeVille, Curtiland
AU - Walsh, Patrick C.
AU - DeWeese, Theodore L.
AU - Carducci, Michael
AU - Schaeffer, Edward M.
AU - Pienta, Kenneth J.
AU - Eisenberger, Mario
AU - Tran, Phuoc T.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Purpose: Local ablative treatment to oligometastatic patients can result in long-term disease-free survival in some cancer patients. The importance of this treatment paradigm in prostate cancer is a rapidly evolving field. Herein, we report on the safety and preliminary clinical outcomes of a modern cohort of oligometastatic prostate cancer (OPC) patients treated with consolidative stereotactic ablative radiation (SABR). Methods: Records of men with OPC who underwent consolidative SABR at our institution were reviewed. SABR was delivered in 1–5 fractions of 5–18 Gray. Kaplan–Meier estimates of local progression-free survival (LPFS), biochemical progression-free survival (bPFS; PSA nadir + 2), distant progression-free survival (DPFS), and time-to-next intervention (TTNI) were calculated. Results: In total, 66 OPC patients were identified with consolidative SABR delivered to 134 metastases: 89 bone, 40 nodal, and 5 viscera. The majority of men (49/66) had hormone-sensitive prostate cancer (HSPC). Crude grade 1 and 2 acute toxicities were 36% and 11%, respectively, with no ≥ grade 3 toxicity. At 1 year, LPFS was 92% and bPFS and DPFS were 69%. Of the 18 men with HSPC who had deferred hormone therapy , 11 (56%) remain disease free following SABR (1-year ADT-FS was 78%). In 17 castration-resistant men, 11 had > 50% prostate-specific antigen (PSA) declines with 1-year TTNI of 30%. Conclusions: Consolidative SABR in OPC is feasible and well tolerated. The heterogeneity and small size of our series limit extrapolation of clinically meaningful outcomes following consolidative SABR in OPC, but our preliminary data suggest that this approach warrants continued prospective study.
AB - Purpose: Local ablative treatment to oligometastatic patients can result in long-term disease-free survival in some cancer patients. The importance of this treatment paradigm in prostate cancer is a rapidly evolving field. Herein, we report on the safety and preliminary clinical outcomes of a modern cohort of oligometastatic prostate cancer (OPC) patients treated with consolidative stereotactic ablative radiation (SABR). Methods: Records of men with OPC who underwent consolidative SABR at our institution were reviewed. SABR was delivered in 1–5 fractions of 5–18 Gray. Kaplan–Meier estimates of local progression-free survival (LPFS), biochemical progression-free survival (bPFS; PSA nadir + 2), distant progression-free survival (DPFS), and time-to-next intervention (TTNI) were calculated. Results: In total, 66 OPC patients were identified with consolidative SABR delivered to 134 metastases: 89 bone, 40 nodal, and 5 viscera. The majority of men (49/66) had hormone-sensitive prostate cancer (HSPC). Crude grade 1 and 2 acute toxicities were 36% and 11%, respectively, with no ≥ grade 3 toxicity. At 1 year, LPFS was 92% and bPFS and DPFS were 69%. Of the 18 men with HSPC who had deferred hormone therapy , 11 (56%) remain disease free following SABR (1-year ADT-FS was 78%). In 17 castration-resistant men, 11 had > 50% prostate-specific antigen (PSA) declines with 1-year TTNI of 30%. Conclusions: Consolidative SABR in OPC is feasible and well tolerated. The heterogeneity and small size of our series limit extrapolation of clinically meaningful outcomes following consolidative SABR in OPC, but our preliminary data suggest that this approach warrants continued prospective study.
KW - Androgen-deprivation therapy
KW - Oligometastatic prostate cancer
KW - Stereotactic ablative radiation therapy
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U2 - 10.1007/s00345-018-2477-2
DO - 10.1007/s00345-018-2477-2
M3 - Article
C2 - 30191396
AN - SCOPUS:85053229771
VL - 37
SP - 2623
EP - 2629
JO - World Journal of Urology
JF - World Journal of Urology
SN - 0724-4983
IS - 12
ER -