Benefits of Using Stereotactic Body Radiotherapy in Patients With Metachronous Oligometastases of Hormone-Sensitive Prostate Cancer Detected by [18F]fluoromethylcholine PET/CT

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Stereotactic body radiation therapy (SBRT) might postpone the start of androgen deprivation therapy (ADT) in patients with oligometastatic recurrence of hormone-sensitive prostate cancer. We included 43 SBRT-treated patients, and a control cohort of 20 non–SBRT-treated patients, in this retrospective study. Patients in the SBRT cohort could start ADT significantly later, and the time till castration resistance was significantly longer. Introduction For patients with oligometastatic recurrence of prostate cancer (PC), stereotactic body radiation therapy (SBRT) represents an attractive treatment option, as it is safe without major side effects. The aim of this study was to investigate the impact of SBRT in delaying the start of androgen deprivation therapy (ADT). Patients and Methods Forty-three patients treated with SBRT for oligometastatic recurrence (< 5 metastases) of hormone-sensitive PC, defined with [18F]fluoromethylcholine positron emission tomography/computed tomography were included. As a control group, 20 patients with oligometastatic disease not treated with SBRT were identified from another hospital. Data were collected retrospectively. Results A post-SBRT prostate-specific antigen (PSA) response was seen in 29 (67.4%) of 43 patients. Median ADT–free survival (ADT-FS) was 15.6 months (95% confidence interval [CI], 11.7-19.5) for the whole group, and 25.7 months (95% CI, 9.0-42.4) for patients with a PSA response. Seven patients were treated with a second course of SBRT because of oligometastatic disease recurrence; the ADT-FS in this group was 32.1 months (95% CI, 7.8-56.5). Compared with the control group, the ADT-FS from first diagnosis of metastasis was significantly longer, with 17.3 (95% CI, 13.7-20.9) months versus 4.19 months (95% CI, 0.0-9.0), P < .001. Also, time between diagnosis of the metastasis until progression of disease during ADT use (castration resistance) was longer for the SBRT-treated patients (mean 66.6, 95% CI, 53.5-79.8, vs. 36.41, 95% CI, 26.0-46.8 months, P = .020). There were no grade III or IV adverse events reported. Conclusion SBRT can safely and effectively be used to postpone ADT in appropriately selected patients with oligometastatic recurrence of PC.

Original languageEnglish
Pages (from-to)e773-e782
JournalClinical Genitourinary Cancer
Volume15
Issue number5
DOIs
Publication statusPublished - 1 Oct 2017

Cite this

@article{8b3d2cf75853455abe57506a7752cd03,
title = "Benefits of Using Stereotactic Body Radiotherapy in Patients With Metachronous Oligometastases of Hormone-Sensitive Prostate Cancer Detected by [18F]fluoromethylcholine PET/CT",
abstract = "Stereotactic body radiation therapy (SBRT) might postpone the start of androgen deprivation therapy (ADT) in patients with oligometastatic recurrence of hormone-sensitive prostate cancer. We included 43 SBRT-treated patients, and a control cohort of 20 non–SBRT-treated patients, in this retrospective study. Patients in the SBRT cohort could start ADT significantly later, and the time till castration resistance was significantly longer. Introduction For patients with oligometastatic recurrence of prostate cancer (PC), stereotactic body radiation therapy (SBRT) represents an attractive treatment option, as it is safe without major side effects. The aim of this study was to investigate the impact of SBRT in delaying the start of androgen deprivation therapy (ADT). Patients and Methods Forty-three patients treated with SBRT for oligometastatic recurrence (< 5 metastases) of hormone-sensitive PC, defined with [18F]fluoromethylcholine positron emission tomography/computed tomography were included. As a control group, 20 patients with oligometastatic disease not treated with SBRT were identified from another hospital. Data were collected retrospectively. Results A post-SBRT prostate-specific antigen (PSA) response was seen in 29 (67.4{\%}) of 43 patients. Median ADT–free survival (ADT-FS) was 15.6 months (95{\%} confidence interval [CI], 11.7-19.5) for the whole group, and 25.7 months (95{\%} CI, 9.0-42.4) for patients with a PSA response. Seven patients were treated with a second course of SBRT because of oligometastatic disease recurrence; the ADT-FS in this group was 32.1 months (95{\%} CI, 7.8-56.5). Compared with the control group, the ADT-FS from first diagnosis of metastasis was significantly longer, with 17.3 (95{\%} CI, 13.7-20.9) months versus 4.19 months (95{\%} CI, 0.0-9.0), P < .001. Also, time between diagnosis of the metastasis until progression of disease during ADT use (castration resistance) was longer for the SBRT-treated patients (mean 66.6, 95{\%} CI, 53.5-79.8, vs. 36.41, 95{\%} CI, 26.0-46.8 months, P = .020). There were no grade III or IV adverse events reported. Conclusion SBRT can safely and effectively be used to postpone ADT in appropriately selected patients with oligometastatic recurrence of PC.",
keywords = "ADT-free survival, Androgen deprivation therapy, Oligometastatic recurrence of prostate cancer, PSA response, SBRT",
author = "Bouman-Wammes, {Esther W.} and {van Dodewaard-De Jong}, {Joyce M.} and Max Dahele and Cysouw, {Matthijs C.F.} and Hoekstra, {Otto S.} and {van Moorselaar}, {R. Jeroen A.} and Piet, {Maartje A.H.} and Verberne, {Hein J.} and Bins, {Adriaan D.} and Verheul, {Henk M.W.} and Slotman, {Ben J.} and Oprea-Lager, {Daniela E.} and {Van den Eertwegh}, {Alfons J.M.}",
year = "2017",
month = "10",
day = "1",
doi = "10.1016/j.clgc.2017.03.009",
language = "English",
volume = "15",
pages = "e773--e782",
journal = "Clinical Genitourinary Cancer",
issn = "1558-7673",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Benefits of Using Stereotactic Body Radiotherapy in Patients With Metachronous Oligometastases of Hormone-Sensitive Prostate Cancer Detected by [18F]fluoromethylcholine PET/CT

AU - Bouman-Wammes, Esther W.

AU - van Dodewaard-De Jong, Joyce M.

AU - Dahele, Max

AU - Cysouw, Matthijs C.F.

AU - Hoekstra, Otto S.

AU - van Moorselaar, R. Jeroen A.

AU - Piet, Maartje A.H.

AU - Verberne, Hein J.

AU - Bins, Adriaan D.

AU - Verheul, Henk M.W.

AU - Slotman, Ben J.

AU - Oprea-Lager, Daniela E.

AU - Van den Eertwegh, Alfons J.M.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Stereotactic body radiation therapy (SBRT) might postpone the start of androgen deprivation therapy (ADT) in patients with oligometastatic recurrence of hormone-sensitive prostate cancer. We included 43 SBRT-treated patients, and a control cohort of 20 non–SBRT-treated patients, in this retrospective study. Patients in the SBRT cohort could start ADT significantly later, and the time till castration resistance was significantly longer. Introduction For patients with oligometastatic recurrence of prostate cancer (PC), stereotactic body radiation therapy (SBRT) represents an attractive treatment option, as it is safe without major side effects. The aim of this study was to investigate the impact of SBRT in delaying the start of androgen deprivation therapy (ADT). Patients and Methods Forty-three patients treated with SBRT for oligometastatic recurrence (< 5 metastases) of hormone-sensitive PC, defined with [18F]fluoromethylcholine positron emission tomography/computed tomography were included. As a control group, 20 patients with oligometastatic disease not treated with SBRT were identified from another hospital. Data were collected retrospectively. Results A post-SBRT prostate-specific antigen (PSA) response was seen in 29 (67.4%) of 43 patients. Median ADT–free survival (ADT-FS) was 15.6 months (95% confidence interval [CI], 11.7-19.5) for the whole group, and 25.7 months (95% CI, 9.0-42.4) for patients with a PSA response. Seven patients were treated with a second course of SBRT because of oligometastatic disease recurrence; the ADT-FS in this group was 32.1 months (95% CI, 7.8-56.5). Compared with the control group, the ADT-FS from first diagnosis of metastasis was significantly longer, with 17.3 (95% CI, 13.7-20.9) months versus 4.19 months (95% CI, 0.0-9.0), P < .001. Also, time between diagnosis of the metastasis until progression of disease during ADT use (castration resistance) was longer for the SBRT-treated patients (mean 66.6, 95% CI, 53.5-79.8, vs. 36.41, 95% CI, 26.0-46.8 months, P = .020). There were no grade III or IV adverse events reported. Conclusion SBRT can safely and effectively be used to postpone ADT in appropriately selected patients with oligometastatic recurrence of PC.

AB - Stereotactic body radiation therapy (SBRT) might postpone the start of androgen deprivation therapy (ADT) in patients with oligometastatic recurrence of hormone-sensitive prostate cancer. We included 43 SBRT-treated patients, and a control cohort of 20 non–SBRT-treated patients, in this retrospective study. Patients in the SBRT cohort could start ADT significantly later, and the time till castration resistance was significantly longer. Introduction For patients with oligometastatic recurrence of prostate cancer (PC), stereotactic body radiation therapy (SBRT) represents an attractive treatment option, as it is safe without major side effects. The aim of this study was to investigate the impact of SBRT in delaying the start of androgen deprivation therapy (ADT). Patients and Methods Forty-three patients treated with SBRT for oligometastatic recurrence (< 5 metastases) of hormone-sensitive PC, defined with [18F]fluoromethylcholine positron emission tomography/computed tomography were included. As a control group, 20 patients with oligometastatic disease not treated with SBRT were identified from another hospital. Data were collected retrospectively. Results A post-SBRT prostate-specific antigen (PSA) response was seen in 29 (67.4%) of 43 patients. Median ADT–free survival (ADT-FS) was 15.6 months (95% confidence interval [CI], 11.7-19.5) for the whole group, and 25.7 months (95% CI, 9.0-42.4) for patients with a PSA response. Seven patients were treated with a second course of SBRT because of oligometastatic disease recurrence; the ADT-FS in this group was 32.1 months (95% CI, 7.8-56.5). Compared with the control group, the ADT-FS from first diagnosis of metastasis was significantly longer, with 17.3 (95% CI, 13.7-20.9) months versus 4.19 months (95% CI, 0.0-9.0), P < .001. Also, time between diagnosis of the metastasis until progression of disease during ADT use (castration resistance) was longer for the SBRT-treated patients (mean 66.6, 95% CI, 53.5-79.8, vs. 36.41, 95% CI, 26.0-46.8 months, P = .020). There were no grade III or IV adverse events reported. Conclusion SBRT can safely and effectively be used to postpone ADT in appropriately selected patients with oligometastatic recurrence of PC.

KW - ADT-free survival

KW - Androgen deprivation therapy

KW - Oligometastatic recurrence of prostate cancer

KW - PSA response

KW - SBRT

UR - http://www.scopus.com/inward/record.url?scp=85018802494&partnerID=8YFLogxK

U2 - 10.1016/j.clgc.2017.03.009

DO - 10.1016/j.clgc.2017.03.009

M3 - Article

VL - 15

SP - e773-e782

JO - Clinical Genitourinary Cancer

JF - Clinical Genitourinary Cancer

SN - 1558-7673

IS - 5

ER -