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Published on: May 8, 2018
Stereotactic body radiotherapy for lung oligometastatic prostate cancer: An international retrospective multicenter
Maximilien Rogé1,2, Patrick Bowden3, Paul Conway3
1Department of Radiation Oncology, Henri Becquerel Cancer Institute, 76000 Rouen, France.
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.
