Triggiani Luca, Alongi Filippo, Buglione Michela, Detti Beatrice, Santoni Riccardo, Bruni Alessio, Maranzano Ernesto, Lohr Frank, D'Angelillo Rolando, Magli Alessandro, Bonetta Alberto, Mazzola Rosario, Pasinetti Nadia, Francolini Giulio, Ingrosso Gianluca, Trippa Fabio, Fersino Sergio, Borghetti Paolo, Ghirardelli Paolo, Magrini Stefano Maria
Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy.
Department of Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
Br J Cancer. 2017 Jun 6;116(12):1520-1525. doi: 10.1038/bjc.2017.103. Epub 2017 Apr 27.
The aim of the present study is to evaluate the impact of metastases-directed stereotactic body radiotherapy in two groups of oligometastatic prostate cancer (PC) patients: oligorecurrent PC and oligoprogressive castration-resistant PC (oligo-CRPC).
Inclusion criteria of the present multicentre retrospective analysis were: (1) oligorecurrent PC, defined as the presence of 1-3 lesions (bone or nodes) detected with choline positron emission tomography or CT plus bone scan following biochemical recurrence; (2) oligo-CRPC, defined as metastases (bone or nodes) detected after a prostatic-specific antigen rise during androgen deprivation therapy (ADT). Primary end points were: distant progression-free survival (DPFS) and ADT-free survival in oligorecurrent PC patients; DPFS and second-line systemic treatment-free survival in oligo-CRPC patients.
About 100 patients with oligorecurrent PC (139 lesions) and 41 with oligo-CRPC (70 lesions), treated between March 2010 and April 2016, were analysed. After a median follow-up of 20.4 months, in the oligorecurrent group 1- and 2-year DPFS were 64.4 and 43%. The rate of LC was 92.8% at 2 years. At a median follow-up of 23.4 months, in the oligo-CRPC group 1- and 2-year DPFS were 43.2 and 21.6%. Limitations include the retrospective design.
Stereotactic body radiotherapy seems to be a useful treatment both for oligorecurrent and oligo-CRPC.
本研究旨在评估针对转移灶的立体定向体部放疗对两组寡转移前列腺癌（PC）患者的影响：寡复发性PC和寡进展性去势抵抗性PC（寡转移性去势抵抗性前列腺癌，oligo-CRPC）。
本多中心回顾性分析的纳入标准为：（1）寡复发性PC，定义为生化复发后通过胆碱正电子发射断层扫描或CT加骨扫描检测到1-3个病灶（骨或淋巴结）；（2）寡转移性去势抵抗性前列腺癌，定义为在雄激素剥夺治疗（ADT）期间前列腺特异性抗原升高后检测到转移灶（骨或淋巴结）。主要终点为：寡复发性PC患者的远处无进展生存期（DPFS）和无ADT生存期；寡转移性去势抵抗性前列腺癌患者的DPFS和无二线全身治疗生存期。
分析了2010年3月至2016年4月期间治疗的约100例寡复发性PC患者（139个病灶）和41例寡转移性去势抵抗性前列腺癌患者（70个病灶）。中位随访20.4个月后，寡复发性组1年和2年的DPFS分别为64.4%和43%。2年时局部控制率为92.8%。中位随访23.4个月时，寡转移性去势抵抗性前列腺癌组1年和2年的DPFS分别为43.2%和21.6%。局限性包括回顾性设计。
立体定向体部放疗似乎对寡复发性和寡转移性去势抵抗性前列腺癌都是一种有效的治疗方法。
