MP37-13 TREATMENT OUTCOMES OF PROGRESSIVE SITE-DIRECTED THERAPY FOR OLIGO-PROGRESSIVE CASTRATION-RESISTANT PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III (MP37)1 Apr 2020MP37-13 TREATMENT OUTCOMES OF PROGRESSIVE SITE-DIRECTED THERAPY FOR OLIGO-PROGRESSIVE CASTRATION-RESISTANT PROSTATE CANCER Soichiro Yoshida*, Taro Takahara, Yuki Arita, Chikako Ishii, Kazuma Toda, Tsuyoshi Sakamoto, Toshiki Kijima, Minato Yokoyama, Junichiro Ishioka, Yoh Matsuoka, Kazutaka Saito, Ryoichi Yoshimura, and Yasuhisa Fujii Soichiro Yoshida*Soichiro Yoshida* More articles by this author , Taro TakaharaTaro Takahara More articles by this author , Yuki AritaYuki Arita More articles by this author , Chikako IshiiChikako Ishii More articles by this author , Kazuma TodaKazuma Toda More articles by this author , Tsuyoshi SakamotoTsuyoshi Sakamoto More articles by this author , Toshiki KijimaToshiki Kijima More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , Junichiro IshiokaJunichiro Ishioka More articles by this author , Yoh MatsuokaYoh Matsuoka More articles by this author , Kazutaka SaitoKazutaka Saito More articles by this author , Ryoichi YoshimuraRyoichi Yoshimura More articles by this author , and Yasuhisa FujiiYasuhisa Fujii More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000886.013AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Locoregional therapy against metastatic prostate cancer has generated great interest.However, the benefit of locoregional therapy for CRPC has not been fully demonstrated. We evaluated the treatment outcomes of locoregional radiotherapy to the oligo-progressive CRPC (OP-CRPC). METHODS: We reviewed 101 consecutive CRPC patients who underwent whole-body MRI with DWI (WB-DWI) before starting a new line of anti-cancer therapy between 2014 and 2019. OP-CRPC patients with 3 or less progressive lesions on WB-DWI were considered for progressive site-directed therapy (PSDT) of all detected progressive lesions without changing systemic therapy. Time to PSA progression after PSDT was calculated from the start of radiotherapy to PSA progression (PSA nadir + 2 ng/ml). RESULTS: Of the 45 (39%) who was diagnosed with OP-CRPC, 27 (60%) underwent PSDT without changing systemic therapy. The most frequent site of PSDT was the pelvic bone (n = 11), followed by the prostate (n = 7). 21 (89%) patients treated with PSDT had a decline in PSA. A decrease in PSA levels of at least 50% in response to PSDT (50% PSA-decline) was observed in 17 (67%) patients. Of the 27 patients treated with PSDT, 18 (67%) experienced PSA progression, and their median time to PSA progression was 6.6 months (range: 2.3-11.8 months). The median follow-up of the remaining 9 patients who did not experience PSA progression was 16.8 months (0.3-29.9 months). Of the potential prognostic variables, PSA-doubling time (PSA-DT) was the significant predictor for time to PSA progression (hazard ratio (HR) 1.3; P = 0.0045), as well as targeted site intra-pelvic localization (HR 3.8; P = 0.036). The PSA-progression-free survival (PSA-PFS) was significantly longer in the OP-CRPC patients with a PSA-DT ≥ 4 months compared with those with a PSA-DT < 4 months (median PSA-PFS: 11.7 vs 6.6 months, P = 0.012). The PSA-PFS was significantly longer in the pelvic OP-CRPC group compared with the non-pelvic OP-CRPC group (median PSA-PFS: 9.0 vs. 4.8 months, P = 0.017). CONCLUSIONS: PSDT to OP-CRPC provided a high treatment effect in terms of PSA response. The patients whose progressive site was localized in the pelvis, and PSA-DT was longer than 4 months were good candidates for PSDT. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e565-e565 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Soichiro Yoshida* More articles by this author Taro Takahara More articles by this author Yuki Arita More articles by this author Chikako Ishii More articles by this author Kazuma Toda More articles by this author Tsuyoshi Sakamoto More articles by this author Toshiki Kijima More articles by this author Minato Yokoyama More articles by this author Junichiro Ishioka More articles by this author Yoh Matsuoka More articles by this author Kazutaka Saito More articles by this author Ryoichi Yoshimura More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement PDF downloadLoading ...