The role of Stereotactic Body Radiation Therapy in Oligometastatic Prostate Cancer
PO-1376
Abstract
The role of Stereotactic Body Radiation Therapy in Oligometastatic Prostate Cancer
Authors: Oscar Muñoz Muñoz1, Ana Maria Burgueño Caballero2, Elias Gomis Selles3, Patricia Cabrera Roldan3, David Miguel Muñoz Carmona4, Blas David Delgado León3
1Hospital Universitario Virgen del Rocio , Oncology Radiation Therapy, Seville, Spain; 2Hospital Universitario Virgen del Rocio, Oncology Radiation Therapy , Sevilla, Spain; 3Hospital Universitario Virgen del Rocio, Oncology Radiation Therapy, Sevilla, Spain; 4Hospital Universitario Virgen del Rocio , Oncology Radiation Therapy, Sevilla, Spain
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Purpose or Objective
High dose (HD) radiotherapy (RT), with radical intent, is used more and more in prostate cancer (PCa) oligometastatic patients (pts) with good outcomes and low toxicity profile. This retrospective study evaluated at the tolerability and outcomes of stereotactic body radiation therapy (SBRT) in patients with oligometastatic PCa treated in our center.
Material and Methods
Pts with 1-2 bone or 1-5 lymph node metastases, treated with radical doses, were considered for this analysis. Between October 2017 to May 2021, 37 patients with oligometastatic PCa were treated in our institute. RT was delivered with helical IMRT prescribing high doses with radical intent. Overall survival, disease-free survival, biochemical progression-free survival, distant progression-free survival and metastases control were evaluated. Toxicity were evaluated with CTCAE4.3 Scale.
Results
Median follow up was 24.2 months (Range 8-43.9). We included 37 patients with 40 lesions. 25 Bone metastases and 15 adenopathies were finally treated. 48,6% were homono-sensitive, 19% castrate resistant and 32,4% became castrate-resistant during followup. 89% were being treated with ADT. Treatment was administered with intensity-modulated radiotherapy guided by daily image by Conebeam and multi-dampening SBRT-system. Treatment dose was 18Gy/24Gy single session or 30 Gy in 3 fractions every other day for bone lesions and 12Gy/18Gy single session or 30 Gy in 3 fractions every other day for adenopathies. Disease-free survival, biochemical progression-free survival and distance-free relapse-free survival were 73%, 75,6% and 78,3% respectively. Overall survival was 94,6 % and metastases control at 2 years was 83,7%.
Toxicity were evaluated with CTCAE4.3 Scale. 33 patients (90%) had no acute genitourinary toxicity and 4 (10%) presented grade 1 acude genitourinary toxicity. For the gastrointestinal toxicity, 32 patients (86,5%) did not present any toxicity while 5 (13,5%) had grade 1 toxicity. Only one patient suffered late-toxicity, pathological fracture 8 months later.
Conclusion
SBRT used in oligometastatic prostate cancer could provide optimal control and result in a safe technique that provides the patient with an alternative in the natural history of their disease.