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BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Oligometastases from prostate cancer: local treatment with stereotactic body radiotherapy (SBRT)

Authors: Gregor Habl, Christoph Straube, Kilian Schiller, Marciana Nona Duma, Markus Oechsner, Kerstin A. Kessel, Matthias Eiber, Markus Schwaiger, Hubert Kübler, Jürgen E. Gschwend, Stephanie E. Combs

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

The impact of local tumor ablative therapy in oligometastasized prostate cancer (PC) is still under debate. To gain data for this approach, we evaluated oligometastasized PC patients receiving stereotactic body radiotherapy (SBRT) to bone metastases.

Methods

In this retrospective study, 15 oligometastasized PC patients with a total of 20 bone metastases were evaluated regarding biochemical progression-free survival (PSA-PFS), time to initiation of ADT, and local control rate (LCR). Three patients received concomitant androgen deprivation therapy (ADT).

Results

The median follow-up after RT was 22.5 months (range 7.0–53.7 months). The median PSA-PFS was 6.9 months (range 1.1–28.4 months). All patients showing a decrease of PSA level after RT of at least factor 10 reveal a PSA-PFS of >12 months. Median PSA-PFS of this sub-group was 23.1 months (range 12.1–28.4 months). Local PFS (LPFS) after 2 years was 100%. One patient developed a local failure after 28.4 months. Median distant PFS (DPFS) was 7.36 months (range 1.74–54.34 months). The time to initiation of ADT in patients treated without ADT was 9.3 months (range 2.6–36.1 months). In all patients, the time to intensification of systemic therapy or the time to initiation of ADT increased from 9.3 to 12.3 months (range 2.6–36.1 months). Gleason-Score, ADT or the localization of metastasis had no impact on PFS or time to intensification of systemic therapy. No SBRT related acute or late toxicities were observed.

Conclusion

Our study shows that SBRT of bone metastases is a highly effective therapy with an excellent risk-benefit profile. However, PFS was limited due to a high distant failure rate implying the difficulty for patient selection for this oligometastatic concept. SBRT offers high local cancer control rates in bone oligometastases of PC and should be evaluated with the aim of curation or to delay modification of systemic treatment.
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Metadata
Title
Oligometastases from prostate cancer: local treatment with stereotactic body radiotherapy (SBRT)
Authors
Gregor Habl
Christoph Straube
Kilian Schiller
Marciana Nona Duma
Markus Oechsner
Kerstin A. Kessel
Matthias Eiber
Markus Schwaiger
Hubert Kübler
Jürgen E. Gschwend
Stephanie E. Combs
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3341-2

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