The current landscape of stereotactic body radiation therapy for metastatic castration-resistant prostate cancer

被引:4
作者
Le Guevelou, Jennifer [1 ]
Cuccia, Francesco [2 ]
Flippot, Ronan [3 ]
Ferrera, Giuseppe [2 ]
Terlizzi, Mario [4 ]
Zilli, Thomas [5 ,6 ,7 ]
De Crevoisier, Renaud [1 ]
Hannoun-Levi, Jean-Michel [8 ]
Supiot, Stephane [9 ]
Sargos, Paul [10 ]
Pasquier, David [11 ,12 ]
机构
[1] Ctr Eugene Marquis, Dept Radiat Therapy, Rennes, France
[2] ARNAS Civ Palermo, Dept Radiat Therapy, Palermo, Italy
[3] Inst Gustave Roussy, Dept Med Oncol, Villejuif, France
[4] Inst Gustave Roussy, Dept Radiat Therapy, Villejuif, France
[5] Oncol Inst Southern Switzerland, EOC, Dept Radiat Oncol, Bellinzona, Switzerland
[6] Univ Svizzera Italiana, Lugano, Switzerland
[7] Univ Geneva, Fac Med, Geneva, Switzerland
[8] Univ Cote dAzur, Ctr Antoine Lacassagne, Dept Radiat Oncol, Nice, France
[9] Inst Cancerol Ouest, Dept Radiat Oncol, Nantes, France
[10] Inst Bergonie, Dept Radiat Oncol, Bordeaux, France
[11] Acad Dept Radiat Oncol, Ctr Oscar Lambret, Lille, France
[12] Lille Univ, CNRS, CRIStAL, UMR 9189, Lille, France
关键词
DOUBLE-BLIND; OLIGOPROGRESSIVE LESIONS; OLIGOMETASTATIC DISEASE; ABLATIVE RADIOTHERAPY; ABIRATERONE ACETATE; PLUS PREDNISONE; OPEN-LABEL; TRIAL; ONCOLOGY; PLACEBO;
D O I
10.1038/s41391-024-00862-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The onset of castration-resistance is associated with dismal outcomes in patients with prostate cancer (PCa). Metastasis directed therapy has been investigated in multiple disease settings and may improve outcomes in selected patients. Our systematic review aims to summarize evidence with stereotactic body radiotherapy (SBRT) in castration-resistant prostate cancer (CRPC). Methods: The literature search was performed on March 2024, on Pubmed, using the keywords "SBRT" AND "CRPC", and "stereotactic ablative radiotherapy (SABR)" AND "CRPC". This search retrieved a total of 108 articles, 19 were included. Results: The literature is largely dominated by retrospective series. In men with metachronous oligoprogression, SBRT with androgen receptor pathway inhibitor significantly increased progression-free survival (PFS) including biochemical progression-free survival in a randomized phase II trial (hazard ratio of 0.35, p < 0.001). In patients continuing ADT, the bPFS ranged between 9.5 months to 17.9 months, and next systemic treatment-free survival (NEST-FS) reached up to 2 years. In men with induced oligoprogression, SBRT enabled NEST-FS up to 3 years. SBRT was well tolerated, with less than 5% grade 3 toxicity reported across studies. Conclusion: In the population of patients with oligometastatic CRPC, SBRT enables long-term biochemical response and PFS. In the oligoprogressive setting, SBRT could be integrated to prolong the duration and efficacy of systemic therapies. Nevertheless, the level of evidence remains very low and inclusion within prospective trials remain the preferred option for this population of patients.
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页数:11
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