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Stereotactic body radiotherapy in oligometastatic prostate cancer patients with isolated lymph nodes involvement: a two-institution experience

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Abstract

Objective

Stereotactic body radiotherapy (SBRT) is emerging as a treatment option in oligometastatic cancer patients. This retrospective study aimed to analyze local control, biochemical progression-free survival (b-PFS), and toxicity in patients affected by isolated prostate cancer lymph node metastases. Finally, we evaluated androgen deprivation therapy-free survival (ADT-FS).

Methods

Forty patients with 47 isolated lymph nodes of recurrent prostate cancer were treated with SBRT. Mostly, two different fractionation schemes were used: 5 × 7 Gy in 23 (48.9 %) lesions and 5 × 8 Gy in 13 (27.7 %) lesions. Response to treatment was assessed with periodical PSA evaluation. Toxicity was registered according to RTOG/EORTC criteria.

Results

With a mean follow-up of 30.18 months, local control was achieved in 98 % of the cases, with a median b-PFS of 24 months. We obtained a 2-year b-PFS of 44 % with 40 % of the patients ADT-free at last follow-up (mean value 26.18 months; range 3.96–59.46), whereas 12.5 % had a mean ADT-FS of 13.58 months (range 2.06–37.13). Late toxicity was observed in one (2.5 %) patient who manifested a grade 3 gastrointestinal toxicity 11.76 months after the end of SBRT.

Conclusion

Our study demonstrates that SBRT is safe, effective, and minimally invasive in the eradication of limited nodal metastases, yielding an important delay in prescribing ADT.

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Authors’ contribution

Gianluca Ingrosso was involved in data collection and management and wrote the manuscript. Fabio Trippa and Elisabetta Ponti were involved in data collection and management and edited the manuscript. Ernesto Maranzano and Riccardo Santoni edited the manuscript. Alessandra Carosi was involved in data management and data analysis and wrote the manuscript. Fabio Arcidiacono and Lorena Draghini were involved in data collection and management. Luana Di Murro and Andrea Lancia wrote the manuscript.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata General Hospital, viale Oxford 81, 00133, Rome, Italy

    Gianluca Ingrosso, Alessandra Carosi, Elisabetta Ponti, Luana Di Murro, Andrea Lancia & Riccardo Santoni

  2. Department of Oncology, Radiation Oncology Center, “S. Maria” Hospital, Terni, Italy

    Fabio Trippa, Ernesto Maranzano, Fabio Arcidiacono & Lorena Draghini

Authors
  1. Gianluca Ingrosso
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  2. Fabio Trippa
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  3. Ernesto Maranzano
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  4. Alessandra Carosi
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  5. Elisabetta Ponti
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  6. Fabio Arcidiacono
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  7. Lorena Draghini
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  8. Luana Di Murro
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  9. Andrea Lancia
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  10. Riccardo Santoni
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Corresponding author

Correspondence to Gianluca Ingrosso.

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Ingrosso, G., Trippa, F., Maranzano, E. et al. Stereotactic body radiotherapy in oligometastatic prostate cancer patients with isolated lymph nodes involvement: a two-institution experience. World J Urol 35, 45–49 (2017). https://doi.org/10.1007/s00345-016-1860-0

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  • DOI: https://doi.org/10.1007/s00345-016-1860-0

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