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Vienna, Austria

ESTRO 2023

Session Item

Sunday
May 14
10:30 - 11:30
Plenary Hall
Genito-urinary
Daniel Matthias Aebersold, Switzerland;
Johannes Knoth, Austria
Proffered Papers
Clinical
11:00 - 11:10
Long -term results of OLIGOPELVIS, a Phase II Trial of pelvic RT in Oligorecurrent Prostate Cancer
Stephane Supiot, France
OC-0434

Abstract

Long -term results of OLIGOPELVIS, a Phase II Trial of pelvic RT in Oligorecurrent Prostate Cancer
Authors:

Stéphane Supiot1, Loig Vaugier2, David Pasquier3, Xavier Buthaud4, Nicolas Magné5, Didier Peiffert6, Paul Sargos7, Gilles Crehange8, Pascal Pommier9, Geneviève Loos10, Ali Hasbini11, Igor Latorzeff12, Marlon Silva13, Fabrice Denis14, Jean-Léon Lagrange15, Cyrille Morvan16, Loic Campion17, Audrey Blanc-Lapierre18, Julie Paul19

1Nantes Université, Radiation Oncology, NANTES, France; 2Institut de Cancérologie de l'Ouest, Radiation Oncology, NANTES, France; 3Centre Oscar Lambret, Radiation Oncology, Lille, France; 4Hôpital privé du confluent, Radiation Oncology, Nantes, France; 5CHU St Etienne, Radiation Oncology, St Etienne, France; 6Institut de Cancérologie de Lorraine, Radiation Oncology, Nancy, France; 7Institut Bergonié, Radiation Oncology, Bordeaux, France; 8Centre GF Leclerc, Radiation Oncology, Dijon, France; 9Centre Léon Bérard, Radiation Oncology, Lyon, France; 10Centre Jean Perrin, Radiation Oncology, Clermont-Ferrand, France; 11Clinique Pasteur, Radiation Oncology, Brest, France; 12Clinique Pasteur, Radiation Oncology, Toulouse, France; 13Centre François Baclesse, Radiation Oncology, Caen, France; 14Centre Jean Bernard, Radiation Oncology, Le Mans, France; 15CHU Créteil, Radiation Oncology, Créteil, France; 16Institut de Cancérologie de l'Ouest, Nuclear oncology, Nantes, France; 17Institut de Cancérologie de l'Ouest, Biostatistics, NANTES, France; 18Institut de cancérologie de l'Ouest, Biostatistics, Nantes, France; 19Institut de Cancérologie de l'Ouest, Biostatistics, Nantes, France

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Purpose or Objective

The regional salvage treatments of oligorecurrent pelvic nodal relapses in prostatic cancer are debated. Androgen depriving therapy (ADT) is a mainstay in metastatic prostate cancer, and salvage SBRT may offer prolonged complete remission for patients harboring regional nodal relapses. Our objective was to assess the efficacy of the combination of ADT and salvage radiotherapy in men with oligorecurrent pelvic node relapses of prostate cancer.

Material and Methods

We conducted an open-label, phase II trial of combined high-dose intensity-modulated radiotherapy (54 Gy in 30 f to the pelvic lymphnodes 66 Gy 30 f to the oligorecurrent pelvic lymphnodes +/- prostate bed irradiation 66 Gy 33f) and ADT (6 months) in oligorecurrent (<6) pelvic node relapses in prostate cancer, detected by fluorocholine PET-CT imaging (OLIGOPELVIS GETUG P07, NCT 02274779). The primary endpoint was 2-yr progression-free survival defined as two consecutive prostate-specific antigen levels above the level at inclusion and/or clinical evidence of progression as per RECIST 1.1 and/or death from any cause. Early toxicity and 2-yr efficacy results were previously reported. Herein we present long-term (5-yr) results.

Results

We analyzed 67 patients (median age 67.7; 54% had received prior prostatic irradiation). Grade 2 + 5-year genito-urinary and gastrointestinal toxicities were 12% and 3%, respectively. Toxicity was comparable between patients with or without a prior history of prostatic irradiation. Five-year progression-free survival, biochemical relapse–free survival, ADT-free survival and overall survival rates were 38.2%, 30.7%, 58.0% and 90.9%, respectively. In multivariate analysis, prior prostatic irradiation was a strong predictor of relapse (HR=0.38, p<0.01). The site of relapses were local (10.5%), N1 (28.5%), M1a (45%), M1b (18%) and M1c (6%).

Conclusion

Combined high-dose salvage elective pelvic radiotherapy and 6-month ADT appeared to prolong tumor control in oligorecurrent pelvic node relapses in prostate cancer with limited toxicity. The site of most relapses following salvage pelvic irradiation is paraortic lymphnodes. After 5 years, 31% of patients were still in complete remission. A randomized trial comparing ADT alone vs ADT + RT is ongoing to confirm these results (Oligopelvis 2 GETUG P12 NCT03630666).