立体定向放射治疗肺少转移性前列腺癌：国际回顾性多中心研究

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology Pub Date : 2025-03-10 DOI:10.1016/j.ctro.2025.100944

Maximilien Rogé , Patrick Bowden , Paul Conway , Ciro Franzese , Marta Scorsetti , Emmanuel Seront , Pierre Blanchard , Mario Terlizzi , Jonathan Khalifa , Corentin Pasquier , Ulrike Shick , Shankar Siva , Julie Paul , Stéphane Supiot

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引用次数: 0

摘要

背景：由于缺乏已发表的数据，前列腺癌（PCa）患者肺寡转移的治疗仍不清楚。目的评价立体定向放射治疗（SBRT）在这种情况下的疗效。设计、环境和参与者我们进行了一项多中心回顾性研究，包括来自3个国家的7个中心的35名接受SBRT治疗肺少转移性前列腺癌患者。通过无进展生存期（PFS）评估疗效，定义为sbrt前PSA + 25%或最低PSA + 25%和+ 2 ng/mL，如果发生在生化进展之前，则放射学进展。评估局部无复发生存期（LRFS）、远处转移生存期（DMFS）、总生存期（OS）和雄激素剥夺治疗的无生存期。使用Kaplan Meier法估计生存率。结果35例患者经PET-CT分期为肺少转移灶的占97%，经组织活检证实为肺少转移灶的占51%。77%为低复发性转移性疾病。SBRT前的中位PSA为1.7 ng/mL [0.8, 3.0]， SBRT后的中位随访时间为28.7个月。中位PFS为21.6个月[95% CI: 21.6；中位DMFS为32.4个月[95% CI: 22.2-NA]。在单变量和多变量模型中，没有参数与PFS显著相关。对于在SBRT前未开始ADT或未同时开始ADT的患者（n = 18）， 1年无ADT生存率估计为87.2%[71.9;100]。结论：与骨和/或淋巴结转移性前列腺癌相比，ssbrt治疗前列腺癌肺部低转移性前列腺癌的预后良好。我们的研究结果鼓励将肺少转移性疾病患者纳入旨在评估SBRT价值的临床试验。前列腺癌肺少转移的brt治疗结果令人鼓舞，类似于骨或淋巴结少转移的治疗。

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Stereotactic body radiotherapy for lung oligometastatic prostate cancer: An international retrospective multicenter study

Background

Management of prostate cancer (PCa) patients with lung oligometastases remains unclear in the absence of published data.

Objective

The aim of this study was to evaluate the efficacy of Stereotactic Body Radiotherapy (SBRT) in this setting.

Design, setting, and participants

We conducted a multicenter retrospective study that included 35 PCa patients treated with SBRT for lung oligometastases in 7 centers across 3 countries.

Outcome measurements and statistical analysis

The efficacy was evaluated by the progression free-survival (PFS), defined as pre-SBRT PSA + 25 % or nadir PSA + 25 % and + 2 ng/mL or radiological progression if it occurred before biochemical progression. The local recurrence free-survival (LRFS), distant metastases free-survival (DMFS), Overall Survival (OS) and Androgen Deprivation Therapy free-survival were also assessed. Survival was estimated using the Kaplan Meier method.

Results

35 patients were included with lung oligometastases staged with PET-CT for 97 % and histologically biopsy confirmed for 51 %. 77 % had an oligorecurrent metastatic disease. The median pre SBRT PSA was at 1.7 ng/mL [0.8, 3.0] and the median follow-up after SBRT was 28.7 months. The median PFS was 21.6 months [95 %CI: 21.6; NA] and the median DMFS was 32.4 months [95 %CI: 22.2–NA]. No parameters were significantly associated with PFS on the univariate and multivariate models.

For patients who did not start ADT before or concomitantly with SBRT (n = 18), the 1-year ADT free-survival rate was estimated at 87.2 % [71.9;100].

Conclusions

SBRT for PCa lung oligometastases offers good oncological outcomes, comparable to those reported for bone and/or lymph node metastases SBRT. Our results encourage the inclusion of patients with lung oligometastatic disease in clinical trials designed to assess the value of SBRT.