Niazi Tamim, Elakshar Sara, Stroian Gabriela
Division of Radiation Oncology, Department of Oncology.
Department of Medical Physics, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Curr Opin Support Palliat Care. 2018 Sep;12(3):351-358. doi: 10.1097/SPC.0000000000000371.
The oligometastases is considered an intermediate state of the disease between localized and wide spread metastases. Local ablative therapy to oligometastatic prostate cancer is gaining significant traction and stereotactic body radiotherapy (SBRT) is an emerging treatment modality for this patient population. In this review, we report our literature review of SBRT to prostate oligometastases. Current evidence on the role of SBRT in oligometastatic prostate cancer reported in the last 10 years was summarized. Criteria for inclusion included studies with prostate cancer only as the primary site.
The unique properties of the oligometastatic prostate cancer appear to carry a better prognosis than wide spread metastatic disease, especially if these metastases are amenable to local ablative therapies. Our literature review revealed that local ablative therapy, using SBRT to prostate oligometastases, is associated with significant 2-years local control and acceptable toxicity profile.
SBRT to oligometastatic prostate cancer patients is feasible and carries an acceptable toxicity profile. The randomized phase II and III trials, currently underway, should clearly define the real benefit of this approach on progression-free and overall survival outcomes.
寡转移被认为是疾病在局限性转移和广泛转移之间的一种中间状态。对寡转移前列腺癌进行局部消融治疗正越来越受到关注，立体定向体部放疗（SBRT）是针对这一患者群体的一种新兴治疗方式。在本综述中，我们报告了对前列腺寡转移灶进行SBRT的文献回顾。总结了过去10年中报道的关于SBRT在寡转移前列腺癌中作用的现有证据。纳入标准包括仅以前列腺癌作为原发部位的研究。
寡转移前列腺癌的独特特性似乎比广泛转移疾病具有更好的预后，尤其是如果这些转移灶适合局部消融治疗。我们的文献回顾显示，对前列腺寡转移灶使用SBRT进行局部消融治疗，与显著的2年局部控制率和可接受的毒性特征相关。
对寡转移前列腺癌患者进行SBRT是可行的，且具有可接受的毒性特征。目前正在进行的随机II期和III期试验应能明确这种方法在无进展生存期和总生存结局方面的实际益处。
