Long‐term clinical outcomes of external beam radiation therapy for oligometastatic prostate cancer: A combination of prostate‐targeted treatment and metastasis‐directed therapy. (2nd April 2021)

• Record Type: Journal Article
• Authors: Aizawa, Rihito; Takayama, Kenji; Nakamura, Kiyonao; Ogata, Takashi; Inoue, Takahiro; Yamasaki, Toshinari; Kobayashi, Takashi; Akamatsu, Shusuke; Tashiro, Yu; Ota, Hideto; Ogawa, Osamu; Mizowaki, Takashi
• Is Part Of: International journal of urology. Volume 28:Number 7(2021)
• Page Start: 749
• Page End: 755
• Publication Date: 2021-04-02
• Subjects: external beam radiation therapy -- metastasis‐directed therapy -- oligometastasis -- prostate cancer -- prostate‐targeted treatment; Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.14567
• Languages: English
• ISSNs: 0919-8172

Abstract

Abstract : Objective: To assess the efficacy of combination of prostate‐targeted treatment and metastasis‐directed therapy for oligometastatic prostate cancer. Methods: We retrospectively evaluated the clinical outcomes of synchronously diagnosed oligometastatic prostate cancer patients treated with external beam radiation therapy for the prostate and all metastatic lesions (≤3 lesions) at Kyoto University Hospital between January 2004 and April 2019. The prescribed dose was basically ≥70 Gy for the prostate with or without whole pelvic irradiation, and ≥45 Gy for the metastatic lesions. Clinical outcomes were compared with a contemporary cohort of 55 synchronous oligometastatic prostate cancer patients treated with the standard of care. Results: In total, 16 consecutive patients with synchronous oligometastatic prostate cancer were analyzed. The median follow‐up period was 7.4 years. The 8‐year overall survival, prostate cancer‐specific survival, biochemical failure‐free, clinical failure‐free and castration‐resistant prostate cancer‐free rates were 64.8%, 71.3%, 38.5%, 47.3% and 67.3%, respectively. No grade 3 or higher radiation‐induced late toxicities occurred. Patients with prostate‐targeted treatment plus metastasis‐directed therapy had a significantly higher castration‐resistant prostate cancer‐free rate than those without prostate‐targeted treatment plus metastasis‐directed therapy ( P = 0.00741). Conclusions: Prostate‐targeted treatment plus metastasis‐directed therapy through external beam radiation therapy can result in favorable long‐term disease‐free and survival outcomes with acceptable morbidities among synchronous oligometastatic prostate cancer patients. Therefore, this approach may represent a promising treatment strategy for this population. Further investigation is required.