Radiotherapy in nodal oligorecurrent prostate cancer.

Pinkawa, Michael; Aebersold, Daniel M.; Böhmer, Dirk; Flentje, Michael; Ghadjar, Pirus; Schmidt-Hegemann, Nina-Sophie; Höcht, Stefan; Hölscher, Tobias; Müller, Arndt-Christian; Niehoff, Peter; Sedlmayer, Felix; Wolf, Frank; Zamboglou, Constantinos; Zips, Daniel; Wiegel, Thomas (2021). Radiotherapy in nodal oligorecurrent prostate cancer. Strahlentherapie und Onkologie, 197(7), pp. 575-580. Springer 10.1007/s00066-021-01778-1

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OBJECTIVE

The current article encompasses a literature review and recommendations for radiotherapy in nodal oligorecurrent prostate cancer.

MATERIALS AND METHODS

A literature review focused on studies comparing metastasis-directed stereotactic ablative radiotherapy (SABR) vs. external elective nodal radiotherapy (ENRT) and studies analyzing recurrence patterns after local nodal treatment was performed. The DEGRO Prostate Cancer Expert Panel discussed the results and developed treatment recommendations.

RESULTS

Metastasis-directed radiotherapy results in high local control (often > 90% within a follow-up of 1-2 years) and can be used to improve progression-free survival or defer androgen deprivation therapy (ADT) according to prospective randomized phase II data. Distant progression after involved-node SABR only occurs within a few months in the majority of patients. ENRT improves metastases-free survival rates with increased toxicity in comparison to SABR according to retrospective comparative studies. The majority of nodal recurrences after initial local treatment of pelvic nodal metastasis are detected within the true pelvis and common iliac vessels.

CONCLUSION

ENRT with or without a boost should be preferred to SABR in pelvic nodal recurrences. In oligometastatic prostate cancer with distant (extrapelvic) nodal recurrences, SABR alone can be performed in selected cases. Application of additional systemic treatments should be based on current guidelines, with ADT as first-line treatment for hormone-sensitive prostate cancer. Only in carefully selected patients can radiotherapy be initially used without additional ADT outside of the current standard recommendations. Results of (randomized) prospective studies are needed for definitive recommendations.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Aebersold, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1439-099X

Publisher:

Springer

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

11 May 2021 09:19

Last Modified:

24 Jun 2021 01:33

Publisher DOI:

10.1007/s00066-021-01778-1

PubMed ID:

33914101

Uncontrolled Keywords:

Androgen deprivation therapy Lymph node metastases Metastasis-directed therapy Oligmometastases Oligorecurrence Prostate cancer Radiation therapy Stereotactic body radiotherapy

BORIS DOI:

10.48350/156186

URI:

https://boris.unibe.ch/id/eprint/156186

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