Efficacy and safety of Prostate stereotactic body radiotherapy for metastatic castration-resistant prostate cancer: A prospective cohort study.

Abstract

BACKGROUND:

The efficacy and safety of prostate SBRT in men with mCRPC is unknown.

MATERIALS AND METHODS:

A prospective cohort study was conducted with 125 men diagnosed with mCRPC. All patients received ADT plus chemotherapy. Patients were randomly assigned to receive daily prostate SBRT (36-48 Gy in 6-8 fractions). Patients who did not receive SBRT served as controls.

RESULTS:

The primary endpoints were PFS and OS. After 89 months of total follow-up, the median PFS was 13.8 months in the SBRT group (n = 61) and 12.0 months in the control group (n = 64) (HR, 0.87; 95% CI, 0.61-1.24; P = 0.249). The OS was 25.7 months in the SBRT group and 23.8 months in the control group (HR, 0.93; 95% CI, 0.65-1.33; P = 0.230). A non-significant increase in the PSA response rate (50.8% vs. 43.7%) and time to PSA progression (8.3 months vs. 7.0 months) was observed in the SBRT group compared to the control group; however, the time to symptomatic progression was significantly prolonged in the SBRT group (11.3 months) compared to the control group (8.5 months) (HR, 0.76; 95% CI, 0.53-1.08; P = 0.019). There was an 11.5% incidence of radiation cystitis and radiation rectitis in the SBRT group, and the degree and incidence of hormone-related and chemotherapy-related adverse events were similar between the two groups.

CONCLUSION:

Adding prostate SBRT significantly prolonged the time to symptomatic progression and non-significantly prolonged PFS and OS among men with mCRPC compared to treatment with ADT plus chemotherapy alone.

• Authors: Jun Li, JunYong Dai, Peng Xian, Lin Xiong, YanPing Song, XianLi Tang, Yuan Li, Yongzhong Wu, Hong Zhou, Nan Liu
• Journal: Cancer treatment and research communications (Cancer Treat Res Commun) Vol. 27 Pg. 100368 ( 2021) ISSN: 2468-2942 [Electronic] England
• PMID: 33848805 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021. Published by Elsevier Ltd.

Chemical References

• Docetaxel
• Gonadotropin-Releasing Hormone
• Prostate-Specific Antigen

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Cystitis (etiology)
• Docetaxel (administration & dosage)
• Dose Fractionation, Radiation
• Follow-Up Studies
• Gonadotropin-Releasing Hormone (agonists, antagonists & inhibitors)
• Humans
• Male
• Neoplasm Grading
• Orchiectomy
• Proctitis (etiology)
• Progression-Free Survival
• Prospective Studies
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms, Castration-Resistant (blood, pathology, therapy)
• Radiation Injuries (etiology)
• Radiosurgery (adverse effects)
• Random Allocation
• Survival Rate
• Tumor Burden