立体定向体部放疗用于肺寡转移前列腺癌：一项国际回顾性多中心研究。
Stereotactic body radiotherapy for lung oligometastatic prostate cancer: An international retrospective multicenter study.
作者信息
Rogé Maximilien, Bowden Patrick, Conway Paul, Franzese Ciro, Scorsetti Marta, Seront Emmanuel, Blanchard Pierre, Terlizzi Mario, Khalifa Jonathan, Pasquier Corentin, Shick Ulrike, Siva Shankar, Paul Julie, Supiot Stéphane
机构信息
Department of Radiation Oncology, Henri Becquerel Cancer Institute, 76000 Rouen, France.
Institut de Cancérologie de l'Ouest, F-44805 Saint Herblain, France.
出版信息
Clin Transl Radiat Oncol. 2025 Mar 10;52:100944. doi: 10.1016/j.ctro.2025.100944. eCollection 2025 May.
BACKGROUND
Management of prostate cancer (PCa) patients with lung oligometastases remains unclear in the absence of published data.
OBJECTIVE
The aim of this study was to evaluate the efficacy of Stereotactic Body Radiotherapy (SBRT) in this setting.
DESIGN SETTING AND PARTICIPANTS
We conducted a multicenter retrospective study that included 35 PCa patients treated with SBRT for lung oligometastases in 7 centers across 3 countries.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
The efficacy was evaluated by the progression free-survival (PFS), defined as pre-SBRT PSA + 25 % or nadir PSA + 25 % and + 2 ng/mL or radiological progression if it occurred before biochemical progression. The local recurrence free-survival (LRFS), distant metastases free-survival (DMFS), Overall Survival (OS) and Androgen Deprivation Therapy free-survival were also assessed. Survival was estimated using the Kaplan Meier method.
RESULTS
35 patients were included with lung oligometastases staged with PET-CT for 97 % and histologically biopsy confirmed for 51 %. 77 % had an oligorecurrent metastatic disease. The median pre SBRT PSA was at 1.7 ng/mL [0.8, 3.0] and the median follow-up after SBRT was 28.7 months. The median PFS was 21.6 months [95 %CI: 21.6; NA] and the median DMFS was 32.4 months [95 %CI: 22.2-NA]. No parameters were significantly associated with PFS on the univariate and multivariate models.For patients who did not start ADT before or concomitantly with SBRT (n = 18), the 1-year ADT free-survival rate was estimated at 87.2 % [71.9;100].
CONCLUSIONS
SBRT for PCa lung oligometastases offers good oncological outcomes, comparable to those reported for bone and/or lymph node metastases SBRT. Our results encourage the inclusion of patients with lung oligometastatic disease in clinical trials designed to assess the value of SBRT.
PATIENT SUMMARY
SBRT for prostate cancer lung oligometastases shows promising results, similar to treatments for bone or lymph node oligometastases.
背景
在缺乏公开数据的情况下，前列腺癌（PCa）肺寡转移患者的管理仍不明确。
目的
本研究旨在评估立体定向体部放疗（SBRT）在此情况下的疗效。
设计、设置和参与者：我们进行了一项多中心回顾性研究，纳入了3个国家7个中心接受SBRT治疗肺寡转移的35例PCa患者。
结果测量和统计分析
疗效通过无进展生存期（PFS）评估，定义为SBRT前PSA + 25%或最低点PSA + 25%且 + 2 ng/mL，或在生化进展前发生的影像学进展。还评估了无局部复发生存期（LRFS）、无远处转移生存期（DMFS）、总生存期（OS）和无雄激素剥夺治疗生存期。使用Kaplan Meier方法估计生存期。
结果
纳入35例肺寡转移患者，97%通过PET-CT分期，51%经组织学活检证实。77%有寡复发转移性疾病。SBRT前PSA中位数为1.7 ng/mL [0.8, 3.0]，SBRT后中位随访时间为28.7个月。中位PFS为21.6个月 [置信区间95%：21.6；无可用值（NA）]，中位DMFS为32.4个月 [置信区间95%：22.2 - NA]。单因素和多因素模型中均无参数与PFS显著相关。对于在SBRT之前或同时未开始雄激素剥夺治疗（ADT）的患者（n = 18），1年无ADT生存率估计为87.2% [71.9；100]。
结论
PCa肺寡转移的SBRT提供了良好的肿瘤学结果，与骨和/或淋巴结转移的SBRT报告结果相当。我们的结果鼓励将肺寡转移疾病患者纳入旨在评估SBRT价值的临床试验。
患者总结
前列腺癌肺寡转移的SBRT显示出有前景的结果，类似于骨或淋巴结寡转移的治疗。
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