Abstract
Oligometastatic prostate cancer is a limited metastatic disease state in which potential long-term control is still possible with the use of targeted therapies such as surgery or stereotactic body radiation therapy (SBRT). SBRT may as well potentially prolong the time before the initiation of androgen deprivation therapy (ADT) and docetaxel chemotherapy for oligometastatic prostate cancer. The goal of this study is to outline prognostic factors associated with improved outcome with SBRT for metastatic prostate cancer and to quantify the effect of prior systemic treatments such as ADT and docetaxel on survival after SBRT. Twenty-four prostate cancer patients were treated with SBRT at the Philadelphia CyberKnife Center between August 2007 and April 2014. Retrospective data collection and analysis were performed for these patients on this Institutional Review Board approved study. Kaplan-Meier methodology was utilized to estimate and visually assess overall survival (OS) at the patient level, with comparisons accomplished using the log-rank test. Unadjusted hazard ratios were estimated using Cox proportional hazards regression modeling. An improved median survival was noted for patients with oligometastatic disease defined as ≤4 lesions with median survival of >3 years compared with 11 months for polymetastases (p = 0.02). The use of docetaxel at some time in follow-up either before or after SBRT was associated with decreased survival with median survival of 9 months vs. >3 years (p = 0.01). Prognosis was better for men with recurrent prostate cancer treated with SBRT if they had ≤4 metastases (oligometastases) or if docetaxel was not necessary for salvage treatment. The prolonged median OS for men with oligometastases in this population of heavily pretreated prostate cancer patients following SBRT may allow for improved quality of life because of a delay of more toxic salvage therapies.
Highlights
According to recent reporting by the National Cancer Institute, ≈15% of men will be diagnosed with prostate cancer in their lifetime [1]
Most of the patients were considered to have castrate-resistant cancer at the time of stereotactic body radiation therapy (SBRT) (n = 20), and 15 patients had progressed after receiving docetaxel therapy
We report our experience in men with metastatic prostate cancer who were treated with SBRT
Summary
According to recent reporting by the National Cancer Institute, ≈15% of men will be diagnosed with prostate cancer in their lifetime [1]. Oligometastatic cancer is a disease state in which long-term control is still possible [2]. The epitomization of this is seen in liver metastasis from primary colon cancers and lung metastasis from sarcoma because resecting these lesions can be curative. Oligometastatic cancers are identified as having a unique biological profile, one that limits its metastatic potential. In this context, the use of targeted therapies, such as stereotactic body radiation therapy (SBRT), may serve to control further spread of the disease [3]. Efforts have been made to combine SBRT with systemic therapies when there is only a limited extent of metastasis, but the contribution of this strategy to progression free survival or overall survival (OS)is yet to be determined for any particular cancer type [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
