Progression-directed therapy in patients with oligoprogressive castration-resistant prostate cancer.

IF 2.5 3区医学 Q2 UROLOGY & NEPHROLOGY

Investigative and Clinical Urology Pub Date : 2024-03-01 DOI:10.4111/icu.20230337

Jun Nyung Lee, Mi Young Kim, Jae Hoon Kang, Jun-Koo Kang, Jae-Wook Chung, Yun-Sok Ha, Seock Hwan Choi, Bum Soo Kim, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo, See Hyung Kim, Tae Gyun Kwon

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引用次数: 0

Abstract

Purpose: Oligoprogressive lesions are observed in a subset of patients who progress to castration-resistant prostate cancer (CRPC), while other lesions remain controlled by systemic therapy. This study evaluates the impact of progression-directed therapy (PDT) on these oligoprogressive lesions.

Materials and methods: This retrospective study included 40 patients diagnosed with oligoprogressive CRPC. PDT was performed for treating all progressive sites using radiotherapy. Fifteen patients received PDT using radiotherapy for all progressive sites (PDT group) while 25 had additional first-line systemic treatments (non-PDT group). In PDT group, 7 patients underwent PDT and unchanged systemic therapy (PDT-A group) and 8 patients underwent PDT with additional new line of systemic therapy on CRPC (PDT-B group). The Kaplan-Meier method was used to assess treatment outcomes.

Results: The prostate specific antigen (PSA) nadir was significantly lower in PDT group compare to non-PDT group (p=0.007). A 50% PSA decline and complete PSA decline were observed in 13 patients (86.7%) and 10 patients (66.7%) of PDT group and in 18 patients (72.0%) and 11 patients (44.0%) of non-PDT group, respectively. The PSA-progression free survival of PDT-B group was significantly longer than non-PDT group. The median time to failure of first-line systemic therapy on CRPC was 30.2 months in patients in PDT group and 14.9 months in non-PDT group (p=0.014). PDT-B group showed a significantly longer time to progression than non-PDT group (p=0.025). Minimal PDT-related adverse events were observed.

Conclusions: PDT can delay progression of disease and enhance treatment efficacy with acceptable tolerability in oligoprogressive CRPC.

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对少进展期抗阉割前列腺癌患者进行进展导向治疗。

目的：在进展为去势抵抗性前列腺癌（CRPC）的患者中，可以观察到少进展性病变，而其他病变仍可通过全身治疗得到控制。本研究评估了进展导向疗法（PDT）对这些寡进展性病变的影响：这项回顾性研究纳入了 40 例确诊为少进展 CRPC 的患者。在使用放疗治疗所有进展部位时都进行了 PDT 治疗。15名患者接受了针对所有进展部位的PDT放疗（PDT组），25名患者接受了额外的一线系统治疗（非PDT组）。在PDT组中，7名患者接受了PDT和不改变的系统治疗（PDT-A组），8名患者接受了PDT和额外的CRPC新一线系统治疗（PDT-B组）。采用卡普兰-梅耶法评估治疗效果：结果：与非PDT组相比，PDT组的前列腺特异性抗原（PSA）最低点明显降低（P=0.007）。前列腺特异性抗原（PSA）下降50%和完全下降的患者分别有13例（86.7%）和10例（66.7%），非前列腺特异性抗原（PSA）下降50%和完全下降的患者分别有18例（72.0%）和11例（44.0%）。PDT-B组的无PSA进展生存期明显长于非PDT组。PDT组患者一线系统治疗失败的中位时间为30.2个月，非PDT组为14.9个月（P=0.014）。PDT-B组患者的病情进展时间明显长于非PDT组（P=0.025）。与PDT相关的不良反应极少：PDT可延缓疾病进展，提高疗效，且对少进展型CRPC的耐受性可接受。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Investigative and Clinical Urology Medicine-Urology

CiteScore

4.10

自引率

4.30%

发文量

审稿时长

4 weeks

期刊介绍： Investigative and Clinical Urology (Investig Clin Urol, ICUrology) is an international, peer-reviewed, platinum open access journal published bimonthly. ICUrology aims to provide outstanding scientific and clinical research articles, that will advance knowledge and understanding of urological diseases and current therapeutic treatments. ICUrology publishes Original Articles, Rapid Communications, Review Articles, Special Articles, Innovations in Urology, Editorials, and Letters to the Editor, with a focus on the following areas of expertise: • Precision Medicine in Urology • Urological Oncology • Robotics/Laparoscopy • Endourology/Urolithiasis • Lower Urinary Tract Dysfunction • Female Urology • Sexual Dysfunction/Infertility • Infection/Inflammation • Reconstruction/Transplantation • Geriatric Urology • Pediatric Urology • Basic/Translational Research One of the notable features of ICUrology is the application of multimedia platforms facilitating easy-to-access online video clips of newly developed surgical techniques from the journal''s website, by a QR (quick response) code located in the article, or via YouTube. ICUrology provides current and highly relevant knowledge to a broad audience at the cutting edge of urological research and clinical practice.