Abstract
PurposeThere are sparse data describing outcomes of bone-only oligometastatic prostate cancer in comparison with lymph node disease treated with stereotactic body radiotherapy (SBRT). The primary aim of this study was to report progression-free survival (PFS) data for patients with bone-only disease. Influence of hormone sensitivity and androgen deprivation therapy use was also assessed.MethodsThis is a single-centre retrospective cohort study. Hormone-sensitive and castrate-resistant patients with oligometastatic (≤ 3) bone-only prostate cancer treated with SBRT were included. Data were collected using electronic records. Kaplan–Meier survivor function, log rank test, as well as Cox regression were used to calculate PFS and overall survival.ResultsIn total, 51 patients with 64 bone metastases treated with SBRT were included. Nine patients were castrate resistant and 42 patient’s hormone sensitive at the time of SBRT. Median follow-up was 23 months. Median PFS was 24 months in hormone-sensitive patients and 3 months in castrate-resistant patients. No patients experienced grade 3 or 4 toxicities. There were three in-field recurrences.ConclusionsIn this study, patients with bone oligometastatic disease showed potential benefit from SBRT with a median PFS of 11 months. Hormone-sensitive patients showed the greatest benefit, with results similar to that published for oligometastatic pelvic nodal disease treated with SBRT. Prospective randomised control trials are needed to determine the survival benefit of SBRT in oligometastatic bone-only prostate cancer and to determine prognostic indicators.
Highlights
Oligometastatic disease (OMD) was first described in 1995 by Hellman and Weischselbaum as a transitional state between a solitary localised tumour and widespread metastatic disease [1]
51 patients with 64 bone metastases treated with stereotactic body radiotherapy (SBRT) were included
Nine patients with 11 bone metastases were castrate-resistant at diagnosis, and the remaining 42 patients were hormone-sensitive at diagnosis of OMD
Summary
Oligometastatic disease (OMD) was first described in 1995 by Hellman and Weischselbaum as a transitional state between a solitary localised tumour and widespread metastatic disease [1]. The clinical significance of recognising OMD is the ability to ablate or surgically remove these. Lesions with the potential of improving survival and delaying further metastases, or even curing the patient. Understanding of OMD has evolved greatly, since it was first described. Oligometastases are identified more, as patients are being imaged frequently with advanced modalities. There is no unified consensus on the maximum number of metastases which defines OMD. Oligometastatic prostate cancer has generally been classified as ≤ 3 metastases in bone or lymph nodes only, whilst other criteria have used up to six [2]
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