TY - JOUR
T1 - Progression-free survival in patients with Ga-68-PSMA-PET-directed SBRT for lymph node oligometastases
AU - Werensteijn-Honingh, Anita M
AU - Wevers, Anne F J
AU - Peters, Max
AU - Kroon, Petra S
AU - Intven, Martijn
AU - Eppinga, Wietse S C
AU - Jürgenliemk-Schulz, Ina M
N1 - Funding Information:
This work was supported by the Dutch Cancer Society under [Grant 2015-0848]. The authors are grateful to Dr. Simon Woodings for comments on the manuscript.
Funding Information:
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The overarching University Medical Centre Utrecht MR-linac scientific project, including employment of multiple authors, has been partly funded by Elekta AB (Stockholm, Sweden). Elekta did not have any part in the design, execution or analysis of this study. Max Peters declares a grant received in August 2017 from the Dutch Cancer Society for the phase 2 PRECISE study regarding focal salvage brachytherapy for radiorecurrent prostate cancer, outside the submitted work. No potential conflict of interest was reported by the author(s).
Publisher Copyright:
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021/10
Y1 - 2021/10
N2 - BACKGROUND: Prostate cancer oligometastatic disease can be treated using stereotactic body radiotherapy (SBRT) in order to postpone start of systemic treatments such as androgen deprivation therapy (ADT). 68Ga-PSMA-PET/CT imaging allows for diagnosis of oligometastases at lower PSA values. We analysed a cohort of patients with prostate cancer lymph node oligometastases detected on PSMA-PET/CT.MATERIALS AND METHODS: Ninety patients with metachronous oligometastatic prostate cancer received SBRT for 1-3 lymph node metastases diagnosed on 68Ga-PSMA-PET/CT. The primary end point was progression free survival (PFS), with disease progression defined as occurrence of either target lesion progression, new metastatic lesion or biochemical progression. Secondary outcomes were biochemical PFS (BPFS), ADT-free survival (ADT-FS), toxicity and quality of life (QoL). Baseline patient characteristics were tested for association with PFS and a preliminary risk score was created.RESULTS: Median follow-up was 21 months (interquartile range 10-31 months). Median PFS and BPFS were 16 and 21 months, respectively. Median ADT-FS was not reached (73% (95%-CI 62-86%) at 24 months). In multivariable analysis, younger age, higher PSA prior to SBRT and extrapelvic location were associated with shorter PFS. Grade 1 fatigue was the most predominant acute toxicity (34%). Highest grade toxicity was grade 2 for acute and late events. QoL analysis showed mild, transient increase in fatigue at 1-4 weeks after SBRT.CONCLUSION: A median PFS of 16 months was attained after SBRT for patients with PSMA-PET positive oligometastatic lymph nodes from prostate cancer. Higher pre-SBRT PSA, younger age and extrapelvic location were found to be predictors of shorter PFS.
AB - BACKGROUND: Prostate cancer oligometastatic disease can be treated using stereotactic body radiotherapy (SBRT) in order to postpone start of systemic treatments such as androgen deprivation therapy (ADT). 68Ga-PSMA-PET/CT imaging allows for diagnosis of oligometastases at lower PSA values. We analysed a cohort of patients with prostate cancer lymph node oligometastases detected on PSMA-PET/CT.MATERIALS AND METHODS: Ninety patients with metachronous oligometastatic prostate cancer received SBRT for 1-3 lymph node metastases diagnosed on 68Ga-PSMA-PET/CT. The primary end point was progression free survival (PFS), with disease progression defined as occurrence of either target lesion progression, new metastatic lesion or biochemical progression. Secondary outcomes were biochemical PFS (BPFS), ADT-free survival (ADT-FS), toxicity and quality of life (QoL). Baseline patient characteristics were tested for association with PFS and a preliminary risk score was created.RESULTS: Median follow-up was 21 months (interquartile range 10-31 months). Median PFS and BPFS were 16 and 21 months, respectively. Median ADT-FS was not reached (73% (95%-CI 62-86%) at 24 months). In multivariable analysis, younger age, higher PSA prior to SBRT and extrapelvic location were associated with shorter PFS. Grade 1 fatigue was the most predominant acute toxicity (34%). Highest grade toxicity was grade 2 for acute and late events. QoL analysis showed mild, transient increase in fatigue at 1-4 weeks after SBRT.CONCLUSION: A median PFS of 16 months was attained after SBRT for patients with PSMA-PET positive oligometastatic lymph nodes from prostate cancer. Higher pre-SBRT PSA, younger age and extrapelvic location were found to be predictors of shorter PFS.
KW - lymph node metastases
KW - metastasis-directed therapy
KW - Oligorecurrent
KW - prostate cancer
KW - stereotactic body radiotherapy
UR - https://www.scopus.com/pages/publications/85111662997
U2 - 10.1080/0284186X.2021.1955970
DO - 10.1080/0284186X.2021.1955970
M3 - Article
C2 - 34323648
SN - 0284-186X
VL - 60
SP - 1342
EP - 1351
JO - Acta Oncologica
JF - Acta Oncologica
IS - 10
ER -