Stereotactic ablative radiotherapy (SABR) for pelvic nodal oligorecurrence in prostate cancer.

IF 1.2 Q4 ONCOLOGY

Reports of Practical Oncology and Radiotherapy Pub Date : 2024-10-03 eCollection Date: 2024-01-01 DOI:10.5603/rpor.101528

Marta Lopez-Valcarcel, Francisco J Valcarcel, Joaquin Velasco, Irma Zapata, Ruth Rodriguez, Jorge Cardona, Beatriz Gil, Sofia Cordoba, Raquel Benlloch, Maria Hernandez, Sofia Santana, Ricardo Gomez, Cristina De la Fuente, M Isabel Garcia-Berrocal, Carlos Regueiro, Jesus Romero

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引用次数: 0

Abstract

Background: This study evaluated the clinical outcomes of stereotactic ablative radiotherapy (SABR) in the treatment of oligometastatic pelvic node prostate cancer to delay androgen deprivation therapy (ADT).

Materials and methods: Pelvic lymph node metastases were identified by ¹¹C-choline positron emission tomography (PET)-computed tomography (CT), and patients were not receiving ADT. SABR was administered using linear accelerators with intensity-modulated and image-guided radiotherapy, at a prescribed dose of 35 Gy in 5 fractions over 2 weeks. Response was assessed using Response Evaluation Criteria in Solid Tumours (RECIST) v1.1 criteria, and prostate-specific antigen (PSA) levels were monitored post-SABR. Toxicity and quality of life were assessed by the Common Terminology Criteria for Adverse Events Toxicity (CTCAE) v.5.0 and European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaires QLQ-C30/QLQ-PR25, respectively. Kaplan-Meier and T-test were used for statistical analysis.

Results: Between June 2015 and November 2023, 56 patients with 85 lesions were treated at our institution. Median follow-up was 30 months [95% confidence interval (CI): 24-33.6]. Prostatectomy was the radical treatment in 85.7% of patients, and radiotherapy in 14.3%. Response rates were 67.1% for complete response, 27.4% for partial response, and 1.4% for stable disease. In-field progression was observed in only 3 lesions (3.5%). The median time to biochemical relapse post-SABR was 15 months (95% CI: 11.4-18.6). Three-year pelvic nodal and distant progression-free survival were 62.5% and 80%, respectively. There was a significant decrease in PSA levels after SABR compared to pretreatment levels (0.77 vs. 2.16 ng/mL respectively, p = 0.001). No grade ≥ 2 genitourinary or gastrointestinal toxicities. The median global health status score was 83.33 points at both time points analysed.

Conclusion: SABR can delay the ADT and provide excellent local control while preserving quality of life.

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立体定向消融放疗（SABR）治疗前列腺癌盆腔淋巴结少发。

背景：本研究评价立体定向消融放疗（SABR）延迟雄激素剥夺治疗（ADT）治疗少转移性盆腔淋巴结前列腺癌的临床效果。材料和方法：采用11c -胆碱正电子发射断层扫描(PET)-计算机断层扫描（CT）鉴别盆腔淋巴结转移，患者未接受ADT治疗。SABR使用线性加速器进行强度调制和图像引导放疗，规定剂量为35 Gy，分5次，超过2周。使用实体肿瘤反应评价标准（RECIST） v1.1标准评估反应，并监测sabr后前列腺特异性抗原（PSA）水平。毒性和生活质量分别采用不良事件通用术语标准毒性（CTCAE v.5.0）和欧洲癌症研究与治疗组织（EORTC）生活质量问卷QLQ-C30/QLQ-PR25进行评估。采用Kaplan-Meier检验和t检验进行统计分析。结果：2015年6月至2023年11月，我院共收治56例患者，共85个病灶。中位随访为30个月[95%可信区间（CI）： 24-33.6]。前列腺切除术占85.7%，放疗占14.3%。完全缓解的有效率为67.1%，部分缓解的有效率为27.4%，病情稳定的有效率为1.4%。仅3个病灶（3.5%）出现病灶内进展。sabr后到生化复发的中位时间为15个月（95% CI: 11.4-18.6）。三年盆腔淋巴结和远处无进展生存率分别为62.5%和80%。与预处理水平相比，SABR后PSA水平显著降低（分别为0.77对2.16 ng/mL, p = 0.001）。无≥2级泌尿生殖系统或胃肠道毒性。在分析的两个时间点上，全球健康状况得分中位数为83.33分。结论：SABR可延缓ADT，提供良好的局部控制，同时保持生活质量。

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

Reports of Practical Oncology and Radiotherapy Multiple-

CiteScore

2.80

自引率

8.30%

发文量

115

审稿时长

16 weeks

期刊介绍： Reports of Practical Oncology and Radiotherapy is an interdisciplinary bimonthly journal, publishing original contributions in clinical oncology and radiotherapy, as well as in radiotherapy physics, techniques and radiotherapy equipment. Reports of Practical Oncology and Radiotherapy is a journal of the Polish Society of Radiation Oncology, the Czech Society of Radiation Oncology, the Hungarian Society for Radiation Oncology, the Slovenian Society for Radiotherapy and Oncology, the Polish Study Group of Head and Neck Cancer, the Guild of Bulgarian Radiotherapists and the Greater Poland Cancer Centre, affiliated with the Spanish Society of Radiotherapy and Oncology, the Italian Association of Radiotherapy and the Portuguese Society of Radiotherapy - Oncology.