Radiotherapy at oligoprogression for metastatic castration-resistant prostate cancer patients: a multi-institutional analysis.
Aged
Androgen Receptor Antagonists
/ therapeutic use
Disease Progression
Follow-Up Studies
Humans
Male
Middle Aged
Positron-Emission Tomography
Progression-Free Survival
Prostate
/ diagnostic imaging
Prostatic Neoplasms, Castration-Resistant
/ diagnostic imaging
Receptors, Androgen
/ blood
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Androgen receptor-targeted therapy
Metastatic castration-resistant prostate cancer
Oligoprogression
Progression-directed therapy
Radiotherapy
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
29
07
2021
accepted:
22
10
2021
pubmed:
9
11
2021
medline:
4
2
2022
entrez:
8
11
2021
Statut:
ppublish
Résumé
To retrospectively estimate the impact of radiotherapy as a progression-directed therapy (PDT) in oligoprogressive metastatic castration-resistant prostate cancer (mCRPC) patients under androgen receptor-target therapy (ARTT). mCRPC patients are treated with PDT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events v4.0. Survival analysis was performed using the Kaplan-Meier method; univariate and multivariate analyses were performed. Fifty-seven patients were analyzed. The median follow-up after PDT was 25.2 months (interquartile, 17.1-44.5). One-year NEST-free survival, r-PFS and OS were 49.8%, 50.4% and 82.1%, respectively. At multivariate analysis, polymetastatic condition at diagnosis of metastatic hormone-sensitive prostate cancer (mHSPC) (HR 2.82, p = 0.004) and PSA doubling time at diagnosis of mCRPC (HR 2.76, p = 0.006) were associated with NEST-free survival. The same variables were associated with r-PFS (HR 2.32, p = 0.021; HR 2.24, p = 0.021). One patient developed late grade ≥ 2 toxicity. Our study shows that radiotherapy in oligoprogressive mCRPC is safe, is effective and seems to prolong the efficacy of ARTT in patients who otherwise would have gone systemic treatment switch, positively affecting disease progression. Prospective trials are needed.
Identifiants
pubmed: 34748151
doi: 10.1007/s11547-021-01424-x
pii: 10.1007/s11547-021-01424-x
doi:
Substances chimiques
Androgen Receptor Antagonists
0
Receptors, Androgen
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
108-116Informations de copyright
© 2021. Italian Society of Medical Radiology.
Références
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