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World Journal of Urology

, Volume 37, Issue 12, pp 2631–2637 | Cite as

Metastasis-directed stereotactic radiotherapy for oligoprogressive castration-resistant prostate cancer: a multicenter study

  • Luca Triggiani
  • Rosario MazzolaEmail author
  • Stefano Maria Magrini
  • Gianluca Ingrosso
  • Paolo Borghetti
  • Fabio Trippa
  • Andrea Lancia
  • Beatrice Detti
  • Giulio Francolini
  • Fabio Matrone
  • Roberto Bortolus
  • Giuseppe Fanetti
  • Ernesto Maranzano
  • Francesco Pasqualetti
  • Fabiola Paiar
  • Marco Lorenzo Bonù
  • Alessandro Magli
  • Alessio Bruni
  • Ercole Mazzeo
  • Ciro Franzese
  • Marta Scorsetti
  • Filippo Alongi
  • Barbara Alicja Jereczek-Fossa
  • Piet Ost
  • Michela Buglione
Original Article

Abstract

Purpose

Herein, we report the clinical outcomes of a multicenter study evaluating the role of SBRT in a cohort of patients affected by oligoprogressive castration-resistant prostate cancer (CRPC).

Materials and methods

This is a retrospective multicenter observational study including eleven centers. Inclusion criteria of the current study were: (a) Karnofsky performance status > 80, (b) histologically proven diagnosis of PC, (c) 1–5 oligoprogressive metastases, defined as progressive disease at bone or nodes levels (detected by means of choline PET/CT or CT plus bone scan) during ADT, (d) serum testosterone level under 50 ng/ml during ADT, (e) controlled primary tumor, (f) patients treated with SBRT with a dose of at least 5 Gy per fraction to a biologically effective dose (BED) of at least 80 Gy using an alpha-to-beta ratio of 3 Gy, (g) at least 6 months of follow-up post-SBRT.

Results

Eighty-six patients for a total of 117 lesions were treated with SBRT. The median follow-up was 30.7 months (range 4–91 months). The median new metastasis-free survival after SBRT was 12.3 months (95% CI 5.5–19.1 months). One- and two-year distant progression-free survival was 52.3% and 33.7%, respectively. Twenty-six out of 86 patients underwent a second course of SBRT due to further oligoprogressive disease: This resulted in a median systemic treatment-free survival of 21.8 months (95% CI 17.8–25.8 months). One-year systemic treatment-free survival was 72.1%.

Conclusion

SBRT appears to be a promising approach in oligoprogressive castration-resistant prostate cancer. Further investigations are warranted.

Keywords

Prostate cancer SBRT CRPC Metastasis-directed therapy Radiotherapy 

Notes

Authors’ contribution

LT, RM and SMM took part in project development. All the authors were involved in data collection and manuscript writing.

Funding

None.

Compliance with ethical standards

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Luca Triggiani
    • 1
  • Rosario Mazzola
    • 2
    Email author
  • Stefano Maria Magrini
    • 1
  • Gianluca Ingrosso
    • 3
  • Paolo Borghetti
    • 1
  • Fabio Trippa
    • 4
  • Andrea Lancia
    • 3
  • Beatrice Detti
    • 5
  • Giulio Francolini
    • 5
  • Fabio Matrone
    • 6
  • Roberto Bortolus
    • 6
  • Giuseppe Fanetti
    • 6
  • Ernesto Maranzano
    • 4
  • Francesco Pasqualetti
    • 9
  • Fabiola Paiar
    • 9
  • Marco Lorenzo Bonù
    • 1
  • Alessandro Magli
    • 10
  • Alessio Bruni
    • 11
  • Ercole Mazzeo
    • 11
  • Ciro Franzese
    • 12
  • Marta Scorsetti
    • 12
    • 14
  • Filippo Alongi
    • 1
    • 2
  • Barbara Alicja Jereczek-Fossa
    • 7
    • 8
  • Piet Ost
    • 13
  • Michela Buglione
    • 1
  1. 1.Radiation Oncology DepartmentUniversity and Spedali Civili HospitalBresciaItaly
  2. 2.Radiation Oncology DepartmentIRCCS, Sacro Cuore Don Calabria HospitalNegrar-VeronaItaly
  3. 3.Department of Radiation Oncology, Policlinico Tor VergataUniversity of RomeRomeItaly
  4. 4.Radiation Oncology Centre“S. Maria” HospitalTerniItaly
  5. 5.Department of Radiation OncologyUniversity of Florence, Azienda Ospedaliero-Universitaria CareggiFlorenceItaly
  6. 6.Department of Radiation OncologyCentro di Riferimento Oncologico di Aviano CRO-IRCCSAvianoItaly
  7. 7.Department of Oncology and Hemato-oncologyUniversity of MilanMilanItaly
  8. 8.Division of RadiotherapyIEO European Institute of Oncology, IRCCSMilanItaly
  9. 9.Department of Radiation OncologyUniversity Hospital S. ChiaraPisaItaly
  10. 10.Department of Radiation OncologyUniversity Hospital of Udine, ASUIUDUdineItaly
  11. 11.Radiotherapy Unit, Oncology and Hematology DepartmentUniversity Hospital of ModenaModenaItaly
  12. 12.IRCCS, Radiotherapy and Radiosurgery DepartmentHumanitas University HospitalMilan-RozzanoItaly
  13. 13.Department of Radiation OncologyGhent University HospitalGhentBelgium
  14. 14.Department of Biomedical SciencesHumanitas UniversityMilan-RozzanoItaly

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