立体定向放射治疗少进展性转移性去势抵抗性前列腺癌后下一次全身治疗的时间。

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2024-12-01 DOI:10.1016/j.adro.2024.101655

Corbin J. Eule MD , Nellowe Candelario MD , Sameer K. Nath MD , Tyler P. Robin MD, PhD

{"title":"立体定向放射治疗少进展性转移性去势抵抗性前列腺癌后下一次全身治疗的时间。","authors":"Corbin J. Eule MD , Nellowe Candelario MD , Sameer K. Nath MD , Tyler P. Robin MD, PhD","doi":"10.1016/j.adro.2024.101655","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Patients with metastatic castrate-resistant prostate cancer (CRPC) with progressive disease generally require a change or escalation in systemic therapy. For patients with limited (1-3) sites of progressive disease (oligoprogression), metastasis-directed therapy with stereotactic body radiation therapy (SBRT) may allow a longer interval before next-line systemic therapy.</div></div><div><h3>Methods and Materials</h3><div>This is a retrospective study of patients with oligoprogressive metastatic CRPC (mCRPC) treated with SBRT at a single center between 2011 and 2022. The primary endpoint was time to next systemic therapy (TTNST) after SBRT stratified by the presence/absence of untreated nonprogressing metastases. Secondary endpoints included TTNST of the overall cohort and median overall survival (OS) after SBRT.</div></div><div><h3>Results</h3><div>Thirty-two patients with oligoprogressive mCRPC received SBRT to 38 metastases. Patients had a median age of 72.5 years (range, 50.6-84.3) and a median PSA of 6.85 ng/mL (range, 0.39-922.0) at the time of SBRT. The most commonly used SBRT regimen was 3000 cGy in 5 fractions (18 metastases, 47.4%). Sixteen patients were treated to all known sites of disease, whereas 16 patients received SBRT to oligoprogressive metastases but had at least 1 untreated nonprogressing metastasis at the time of SBRT. Patients had received a median of 1.0 prior line of androgen receptor signaling inhibitors and were predominantly (26 patients, 81.3%) chemotherapy naïve. Following SBRT, the median TTNST was 10.1 months and the median OS was 41.3 months. For patients with 0 versus ≥1 untreated nonprogressing metastasis, TTNST was 11.3 versus 8.7 months, respectively (HR, 0.67; 95% CI, 0.33-1.36, logrank <em>P</em> = .24). There was no grade ≥3 toxicities because of SBRT.</div></div><div><h3>Conclusions</h3><div>In this cohort, patients with oligoprogressive mCRPC treated with SBRT delayed the next line of systemic therapy for a median of 10.1 months. SBRT in patients with oligoprogressive mCRPC may delay initiation of the next-line systemic therapy in well-selected patients, including those with ≥1 untreated nonprogressing metastasis.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101655"},"PeriodicalIF":2.2000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605447/pdf/","citationCount":"0","resultStr":"{\"title\":\"Time to Next Systemic Therapy After Stereotactic Body Radiation Therapy for Oligoprogressive Metastatic Castrate-Resistant Prostate Cancer\",\"authors\":\"Corbin J. Eule MD , Nellowe Candelario MD , Sameer K. Nath MD , Tyler P. Robin MD, PhD\",\"doi\":\"10.1016/j.adro.2024.101655\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>Patients with metastatic castrate-resistant prostate cancer (CRPC) with progressive disease generally require a change or escalation in systemic therapy. For patients with limited (1-3) sites of progressive disease (oligoprogression), metastasis-directed therapy with stereotactic body radiation therapy (SBRT) may allow a longer interval before next-line systemic therapy.</div></div><div><h3>Methods and Materials</h3><div>This is a retrospective study of patients with oligoprogressive metastatic CRPC (mCRPC) treated with SBRT at a single center between 2011 and 2022. The primary endpoint was time to next systemic therapy (TTNST) after SBRT stratified by the presence/absence of untreated nonprogressing metastases. Secondary endpoints included TTNST of the overall cohort and median overall survival (OS) after SBRT.</div></div><div><h3>Results</h3><div>Thirty-two patients with oligoprogressive mCRPC received SBRT to 38 metastases. Patients had a median age of 72.5 years (range, 50.6-84.3) and a median PSA of 6.85 ng/mL (range, 0.39-922.0) at the time of SBRT. The most commonly used SBRT regimen was 3000 cGy in 5 fractions (18 metastases, 47.4%). Sixteen patients were treated to all known sites of disease, whereas 16 patients received SBRT to oligoprogressive metastases but had at least 1 untreated nonprogressing metastasis at the time of SBRT. Patients had received a median of 1.0 prior line of androgen receptor signaling inhibitors and were predominantly (26 patients, 81.3%) chemotherapy naïve. Following SBRT, the median TTNST was 10.1 months and the median OS was 41.3 months. For patients with 0 versus ≥1 untreated nonprogressing metastasis, TTNST was 11.3 versus 8.7 months, respectively (HR, 0.67; 95% CI, 0.33-1.36, logrank <em>P</em> = .24). There was no grade ≥3 toxicities because of SBRT.</div></div><div><h3>Conclusions</h3><div>In this cohort, patients with oligoprogressive mCRPC treated with SBRT delayed the next line of systemic therapy for a median of 10.1 months. SBRT in patients with oligoprogressive mCRPC may delay initiation of the next-line systemic therapy in well-selected patients, including those with ≥1 untreated nonprogressing metastasis.</div></div>\",\"PeriodicalId\":7390,\"journal\":{\"name\":\"Advances in Radiation Oncology\",\"volume\":\"9 12\",\"pages\":\"Article 101655\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605447/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Advances in Radiation Oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2452109424002185\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Radiation Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2452109424002185","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：进展性转移性去势抵抗性前列腺癌（CRPC）患者通常需要改变或增加全身治疗。对于有限（1-3个）部位的进展性疾病（少进展）患者，定向转移治疗与立体定向全身放射治疗（SBRT）可能允许更长的间隔时间再进行下一步全身治疗。方法和材料：这是一项回顾性研究，研究对象是2011年至2022年间在单中心接受SBRT治疗的少进展性转移性CRPC （mCRPC）患者。主要终点是SBRT后进行下一次全身治疗（TTNST）的时间，根据未治疗的非进展性转移灶的存在/不存在进行分层。次要终点包括整个队列的TTNST和SBRT后的中位总生存期（OS）。结果：32例少进展性mCRPC患者接受了SBRT治疗，38例转移。患者接受SBRT时的中位年龄为72.5岁（范围为50.6-84.3），中位PSA为6.85 ng/mL（范围为0.39-922.0）。最常用的SBRT方案是3000 cGy，分5个部分（18例转移，47.4%）。16例患者接受了所有已知部位的治疗，而16例患者接受了SBRT治疗，但在SBRT治疗时至少有1例未经治疗的非进展性转移灶。患者先前接受的雄激素受体信号抑制剂中位数为1.0，主要（26例，81.3%）化疗naïve。SBRT后，中位TTNST为10.1个月，中位OS为41.3个月。对于0和≥1例未经治疗的非进展性转移的患者，TTNST分别为11.3和8.7个月(HR, 0.67；95% CI, 0.33-1.36，大秩P = 0.24)。SBRT没有引起≥3级的毒性反应。结论：在该队列中，接受SBRT治疗的少进行性mCRPC患者将下一轮全身治疗延迟了10.1个月。少进展性mCRPC患者的SBRT可能会延迟选定患者的下一步全身治疗的开始，包括那些未经治疗的非进展性转移的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Time to Next Systemic Therapy After Stereotactic Body Radiation Therapy for Oligoprogressive Metastatic Castrate-Resistant Prostate Cancer

Purpose

Patients with metastatic castrate-resistant prostate cancer (CRPC) with progressive disease generally require a change or escalation in systemic therapy. For patients with limited (1-3) sites of progressive disease (oligoprogression), metastasis-directed therapy with stereotactic body radiation therapy (SBRT) may allow a longer interval before next-line systemic therapy.

Methods and Materials

This is a retrospective study of patients with oligoprogressive metastatic CRPC (mCRPC) treated with SBRT at a single center between 2011 and 2022. The primary endpoint was time to next systemic therapy (TTNST) after SBRT stratified by the presence/absence of untreated nonprogressing metastases. Secondary endpoints included TTNST of the overall cohort and median overall survival (OS) after SBRT.

Results

Thirty-two patients with oligoprogressive mCRPC received SBRT to 38 metastases. Patients had a median age of 72.5 years (range, 50.6-84.3) and a median PSA of 6.85 ng/mL (range, 0.39-922.0) at the time of SBRT. The most commonly used SBRT regimen was 3000 cGy in 5 fractions (18 metastases, 47.4%). Sixteen patients were treated to all known sites of disease, whereas 16 patients received SBRT to oligoprogressive metastases but had at least 1 untreated nonprogressing metastasis at the time of SBRT. Patients had received a median of 1.0 prior line of androgen receptor signaling inhibitors and were predominantly (26 patients, 81.3%) chemotherapy naïve. Following SBRT, the median TTNST was 10.1 months and the median OS was 41.3 months. For patients with 0 versus ≥1 untreated nonprogressing metastasis, TTNST was 11.3 versus 8.7 months, respectively (HR, 0.67; 95% CI, 0.33-1.36, logrank P = .24). There was no grade ≥3 toxicities because of SBRT.

Conclusions

In this cohort, patients with oligoprogressive mCRPC treated with SBRT delayed the next line of systemic therapy for a median of 10.1 months. SBRT in patients with oligoprogressive mCRPC may delay initiation of the next-line systemic therapy in well-selected patients, including those with ≥1 untreated nonprogressing metastasis.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.