Long-Term Outcomes of Patients on a Phase II Prospective Trial of Oligometastatic Hormone-Sensitive Prostate Cancer Treated With Androgen Deprivation and External Beam Radiation.

Abstract

PURPOSE:

External beam radiation therapy (EBRT) to oligometastases may improve outcomes in patients with oligometastatic hormone-sensitive prostate cancer (oHSPC). Follow-up on this cohort has been limited to <5 years and prospective data on de novo patients with oHSPC are lacking. We reviewed the long-term outcomes of patients with oHSPC treated with EBRT and androgen deprivation therapy on a prospective trial.

METHODS AND MATERIALS:

From 2006 to 2011, patients with oHSPC with 1 to 5 metastases received 36 weeks of androgen deprivation therapy (luteinizing hormone-releasing hormone agonist + bicalutamide) and up to 53 Gy to all visible metastases. When indicated, the primary tumor or prostate bed was treated with EBRT up to 78 or 66 Gy, respectively.

RESULTS:

Twenty-nine patients were treated: 15 de novo, 14 oligorecurrent, and 21 patients (72.4%) had bone metastases. Median number of metastases per patient was 1 (range, 1-5). EBRT was administered to 52 lesions (38 bone, 12 pelvic lymph nodes [LNs], 2 nonpelvic LNs) up to 53 Gy (range, 47-66). Median follow-up was 9.9 years (years; range, 0.2-14.4). Median overall survival was 9.7 years (95% confidence interval [CI], 5.8-not reached). Median progression-free survival was 1.9 years (95% CI, 1.6-2.2). Patients who presented with prostate cancer-defined de novo metastases had significantly improved (P = .04) median progression-free survival (2.0 years; 95% CI, 1.3-6.0) compared with oligorecurrent patients (1.8 years; 95% CI, 1.0-2.0). Patients who presented with LN-only metastases had numerically improved (P = .13) median PFS (5.8 years; 95% CI, 1.2-not reached) compared with patients with bony metastases (1.8 years; 95% CI, 1.3-2.0). At last follow-up, 17 patients (58.6%) had local control of all EBRT-treated metastases. The metastases that locally progressed had previously been controlled for median 3.5 years (range, 1.7-10.5).

CONCLUSIONS:

Our results compare favorably with other reported studies of patients with oHSPC and provide new insights into their long-term outcomes.

• Authors: Claire Hao, Colton Ladbury, Yung Lyou, Saro Manoukian, Christopher Ruel, Paul Frankel, Tanya Dorff, Jeffrey Wong, Sumanta Pal, Przemyslaw Twardowski, Savita Dandapani
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 114 Issue 4 Pg. 705-710 (11 15 2022) ISSN: 1879-355X [Electronic] United States
• PMID: 35803445 (Publication Type: Journal Article, Review, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• Androgen Antagonists
• Androgens
• Gonadotropin-Releasing Hormone
• Prostate-Specific Antigen

Topics

• Androgen Antagonists (therapeutic use)
• Androgens
• Bone Neoplasms (drug therapy, radiotherapy)
• Clinical Trials, Phase II as Topic
• Gonadotropin-Releasing Hormone
• Humans
• Male
• Prospective Studies
• Prostate-Specific Antigen
• Prostatic Neoplasms (drug therapy, pathology, radiotherapy)