ANU Open Research Repository has been upgraded. We are still working on a few minor issues, which may result in short outages throughout the day. Please get in touch with repository.admin@anu.edu.au if you experience any issues.
 

Fractionated stereotactic body radiotherapy for up to five prostate cancer oligometastases: Interim outcomes of a prospective clinical trial

Date

2020

Authors

Bowden, Patrick
See, Andrew W.
Frydenberg, Mark
Haxhimolla, Hodo
Costello, Anthony J
Moon, Daniel
Ruljancich, Paul
Grummet, Jeremy
Pranavan, Ganesalingam
Gwini, Stella

Journal Title

Journal ISSN

Volume Title

Publisher

John Wiley & Sons Inc

Abstract

Stereotactic body radiotherapy (SBRT) can delay escalation to systemic treatment in men with oligometastatic prostate cancer (PCa). However, large, prospective studies are still required to evaluate the efficacy of this approach in different patient groups. This is the interim analysis of a prospective, single institution study of men relapsing with up to five synchronous lesions following definitive local treatment for primary PCa. Our aim was to determine the proportion of patients not requiring treatment escalation following SBRT. In total, 199 patients were enrolled to receive fractionated SBRT (50 Gray in 10 fractions) to each visible lesion. Fourteen patients were castration resistant at enrolment. The proportion of patients not requiring treatment escalation 2 years following SBRT was 51.7% (95% CI: 44.1–59.3%). The median length of treatment escalation-free survival over the entire follow-up period was 27.1 months (95% CI; 21.8–29.4 months). Prior androgen deprivation therapy (ADT) predicted a significantly lower rate of freedom from treatment escalation at 2 years compared to no prior ADT (odds ratio = 0.21, 95% CI: 0.08–0.54, p = 0.001). There was no difference in the efficacy of SBRT when treating 4–5 vs. 1–3 initial lesions. A prostate-specific antigen (PSA) decline was induced in 75% of patients, with PSA readings falling to an undetectable level in six patients. No late grade three toxicities were observed. These interim results suggest that SBRT can be used to treat up to five synchronous PCa oligometastases to delay treatment escalation.

Description

Keywords

androgen deprivation therapy, oligometastases, prostate cancer, stereotactic body radiotherapy

Citation

Source

International Journal of Cancer

Type

Journal article

Book Title

Entity type

Access Statement

License Rights

DOI

10.1002/ijc.32509

Restricted until

2099-12-31