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Open Access 01-12-2019 | Prostate Cancer | Research article

Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience

Authors: Christoph Oehler, Michel Zimmermann, Lukas Adam, Juergen Curschmann, Marcin Sumila, Räto T. Strebel, Richard Cathomas, Qiyu Li, Uwe Schneider, Daniel R. Zwahlen

Published in: BMC Urology | Issue 1/2019

Abstract

Background

In patients presenting with limited nodal recurrence following radical prostatectomy (RP), stereotactic body radiotherapy (SBRT) results might improve with a better case selection.

Methods

Single-institution retrospective analysis of patients presenting with 1–3 lymph node (LN) recurrences (N1 or M1a) on 18F-Choline PET/CT. Prior therapy included radical prostatectomy (RP) ± salvage radiotherapy (RT), in absence of any systemic therapy.

Outcome parameters were biochemical response (BR), time to biochemical recurrence (TBR) and time interval between SBRT and androgen deprivation therapy start (TADT). Time to event endpoints was analysed using Kaplan-Meier method. Potential prognostic factors were examined using univariate proportional hazards regression for TADT and logistic regression for BR. The optimal cut-off point for LN size was calculated using the Contal and O’Quigley method.

Results

25 patients fulfilling study criteria were treated with SBRT from January 2010 to January 2015 and retrospectively analysed. Median follow up was 18 months and median LN diameter 10.5 mm. SBRT was delivered to a median dose of 36 Gy in three fractions (range: 30–45 Gy). BR was reached in 52% of cases. Median TBR was 11.9 months and significantly longer in patients with larger LN (Hazard ratio [HR] = 0.87, P = 0.03). Using 14 mm as cut off for LN, median TBR was 10.8 months for patients with small LN (18 patients), and 21.2 months for patients with large LN (6 patients) (P unadjusted = 0.009; P adjusted = 0.099). ADT was started in 32% of patients after a median follow-up of 18 months.

Conclusions

For PCa patients with 1–3 LN recurrence after RP (± salvage RT), SBRT might result in a better biochemical control when delivered to larger sized (≥ 14 mm) LN metastases. This study is hypothesis generating and results should be tested in a larger prospective trial.

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Title: Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience
Authors: Christoph Oehler
Michel Zimmermann
Lukas Adam
Juergen Curschmann
Marcin Sumila
Räto T. Strebel
Richard Cathomas
Qiyu Li
Uwe Schneider
Daniel R. Zwahlen
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Prostate Cancer
Metastasis
Prostate Cancer
Radiotherapy
Published in: BMC Urology / Issue 1/2019
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-019-0515-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Predictive factors for response to salvage stereotactic body radiotherapy in oligorecurrent prostate cancer limited to lymph nodes: a single institution experience

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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